EDI Support Services

September 4, 2018

Scheduled Distribution


EDISS to End Support of Modem Technology

For All Modem Users

With technology and connectivity advancements through the years, modem technology has outlived its relevancy within the Healthcare industry. Noridian Healthcare Solutions (NHS) has begun its efforts to sunset support of modem technologies.

NHS will no longer support modem functionality after October 1, 2018. This is the fourth notification EDI Support Services (EDISS)  has issued on this change.

If you have not established an alternative submission method to modem functionality by October 1, 2018, you will not be able to transmit your claims electronically, which may result in payment disruption.

Any provider or vendor who utilizes modems for connectivity and data exchange with Noridian will need to find alternative methods for their connectivity.

NOTE: The availability of ABILITY | PC-ACE will not be impacted by modem sunsetting.

Many submitters who still utilize modems may not be aware of the alternative connectivity options available to them. Network Service Vendors (NSVs) offer many affordable, user-friendly connectivity options which allow submitters to utilize a secure SFTP internet connection for file transfers.

A listing of NSVs conducting business with NHS can be found by going to www.edissweb.com, selecting your state, and clicking the link at the end of the EDISS to End Support of Modem Technology article under the What’s New section. NHS has worked with this community to highlight their offerings and price points. Selecting the individual links will take you to each of their respective websites for this information.

NHS and EDISS cannot assist with making this decision for your organization. We encourage your facility to research and determine which NSV fits with your unique needs.

NOTE: If your facility already submits directly with an NSV or utilizes a Clearinghouse or Billing Service, your submission method will not need to change.


Submitter Not Approved Rejection

For All Submitters

What does it mean when a claim file receives an A8:496:85 rejection on a 277CA report with the message “Submitter Not Approved”? EDI Support Services (EDISS) often receives calls related to this rejection and wanted to provide a few of the more common reasons that this rejection occurs and what to check.

Reason

What to Check

837 Transaction is not in production

  • Provider should log into their EDISS Connect account to verify that they are in production for the 837 transaction.
  • If sending direct via a Network Service Vendor (NSV), make sure the “I will and/or” option is selected for the 837 transaction. If utilizing a Billing Service or Clearinghouse, make sure that the correct vendor Submitter ID is listed in Connect.

Rendering NPI is being sent as the billing NPI (Professional lines of business only)

  • Verify that the NPI that is being sent in the claim file in loop 2010AA NM109, is the billing NPI.

Note: The rendering NPI would be located in loop 2310B NM109 or the 2420A NM109, if different from what is sent in 2310B NM109.

Tax ID being sent in the file is not on file with the payer

  • Verify that the Tax ID being sent in loop 2010AA REF is valid for the NPI that is being sent in the claim file.

Incorrect Submitter ID is being sent

  • For Medicare JF and Commercial: The GS02 and loop 1000A NM109, need to reflect the Submitter ID associated in Connect with the billing NPI listed in the claim file.
  • For Medicare JE: The ISA06, GS02 and loop 1000A NM109 should all match and contain either the direct Submitter’s ID/billing group number or they should all indicate the vendors Submitter ID.

Incorrect payer ID is being sent in the file

  • The payer ID indicated in the ISA08, loop 1000B NM109 and 2010BB NM109 should all match the line of business indicated in Connect. For a list of payer IDs, visit www.edissweb.com and select Contractor IDs under the Quick Links on the Home page.

EDI Support Services Contact Information:

Electronic Data Interchange Support Services (EDISS) is the EDI solution for various healthcare payers. EDISS exchanges electronic data for both Medicare and commercial business.

LOB

STATES

PHONE

Jurisdiction E (JE) Part A and B

CA, NV, HI, Guam, American Samoa, Northern Mariana Islands

855-609-9960

Jurisdiction F (JF)
Medicare A and B

AK, AZ, ID, MT, ND, OR, SD, UT, WA, WY

877-908-8431

Blue Cross/Blue Shield

ND, WY

800-967-7902

Medicaid

ND, IA

800-967-7902

WSI, Vision and Dental

ND

800-967-7902

BCBSWY Dental

WY

800-967-7902

Fax:

EMail:

Website:

1-701-277-7850

support@edissweb.com

www.edissweb.com

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