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Provider using a Billing Service/Clearinghouse

Connectivity Changes

Providers may interact with a Billing Service/Clearinghouse for connectivity in different ways. If your vendor supports connectivity to EDISS on your behalf, you may skip to the Transactional Changes section of this page.

If you are a Provider that uses a Billing Service/Clearinghouse for electronic transactions but are responsible for submitting your own claims to EDISS, please reference the appropriate connectivity changes section that affect you below.

 

Modem Specific Changes

Direct Modem (Asynchronous) connectivity will continue to be supported in the new processing solution, however there will be changes that submitters will have to account for:

  • Z Modem will be the only supported protocol.
  • A new Production phone number will be used for the new Gateway solution.
    • This will be distributed with your new Gateway credentials to the fax number listed in our EDISS Connect registration system.
  • BBS Menu Option changes-
    • Overall, the look and feel of the new BBS will be different.
    • Listing reports for re-download will no longer be an option.
    • Reports and/or Remits that are previously downloaded will no longer be able to be listed for re-download.
      • The EDISS Call Center would need to be contacted to requeue a report or remit for a second retrieval.
  • User Credential change-
    • All Modem users will be provided new logins and passwords for the new Gateway.
    • Modem Users will no longer be required to have a special character in their User ID. (Example: bs12345@BS12345 will now log into the Gateway by using just BS12345)
  • Password Change Process Adjustment
    • Password expiration prompts will begin to appear 5 days prior to expiration.
      • Passwords can be changed proactively at any time within the BBS Menu.
    • Submitters who do not script password changes can utilize the following password management website: https://accountmgt2.edissweb.com/
    • The new gateway will allow for passwords to be 8 to 16 characters in length.
      • Passwords will still need to be alpha numeric with one special symbol.
      • '&' and '+' cannot be used in the new gateway.
  • Scripting adjustments
    • Submitters currently utilizing an automated script for sending/receiving files to EDISS, will need to adjust script(s) as some Gateway menu options and outbound file names will be changing.
      • Outbound file name changes are outlined below.

 

Network Service Vendor (NSV) Changes

Your facility may contract with a connectivity reseller (NSV) for electronic file transfers with EDISS. EDISS has been working with all NSVs to ensure they are prepared for the transition. If your NSV has questions, they can contact EDISS for assistance.

Any Submitter who manages their own NSV connection should be aware of the change in directory structure of the new Gateway. Please note the following:

Directory structure for NSV users will be:

  • New Submitter path for file submission: /outbox/X12/EDI/Inbound/Interchange
  • New Submitter path for file retrieval: /inbox/EZComm/EDI/Inbound/Interchange

 
Compressed or Zipped files will need to be submitted to a different directory than standard X12 files.

  • Path to compressed file submission: /outbox/EZComm/EDI/Inbound/Interchange

 

Transactional Changes

Regardless of connectivity method to EDI, all electronic submitters will have to adjust for specific transactional changes occurring with the Gateway transition. These changes will be updated in the EDISS Companion guides in the near future. Transactional Changes listed below may not have an impact on your organization.

  • ISA05/ISA07 qualifier restriction
    • EDISS has defined ZZ, 01, 27, 28 and 29 as allowed values for these data elements.
  • Defined ISA08 values
    • Submitters currently have set values that should be sent in the ISA08 based on Line of Business, or they can default this to 33477.
  • For all returned 835, 999 and 277CA's, the following values are changing in the order they populate in the x12 file:
    • GS02 values will now reflect Noridian based payer id values. (Example: 0026, 03202, etc)
    • GS03 values will now reflect Noridian issued submitter id values. (Example: ND12345)
  • TA1 reports that generate with errors will deliver to submitters regardless of ISA14 sent in an electronic file.
  • Elimination of the TRN transaction
    • The TRN is not a standard HIPAA report. To align with industry standards EDISS will not be returning this moving forward.
  • All returned reports and remits from the new gateway will be unstrung ANSI data (i.e., multiple lines vs. a single string).
  • Outbound file naming conventions will be changing. The below table provides an overview of those changes:
Batch Partner File <OriginalFileFromPartner>
TA1 <UniqueID>_<OriginalFileFromPartner>_TA1.edi
999 <UniqueID>_<OriginalFileFromPartner>_999.edi
277CA <UniqueID>_<OriginalFileFromPartner>_277CA.edi
277 <UniqueID-hhmmssnn>_<SourceFileFromPayer>_File#_277.edi
835 <UniqueID-hhmmssnn>_<PredefinedValue>_ File#_835.edi

 

  • If you conduct 200 series Batch transactions (270/271, 276/277, 278) with EDISS, outbound file naming conventions will be changing for those transactions as well.
    • NOTE: Transaction availability may differ based on Line of Business conducted with Noridian.
FastBatch Partner File <OriginalFileFromPartner>
TA1 <UniqueID>_<OriginalFileFromPartner>_TA1.edi
999 <UniqueID>_<OriginalFileFromPartner>_999.edi
271 <UniqueID>_<OriginalFileFromPartner>_271.edi
277 <UniqueID>_<OriginalFileFromPartner>_277.edi
278 <UniqueID>_<OriginalFileFromPartner>_278-11.edi

 

  • JE Medicare Part A 835's will no longer be generated with the PTAN/OSCAR value in the ISA08. Instead, the ISA08 value will represent the 835 recipient Trading Partner ID that matches EDISS Connect.