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PBSI Administers TriSpan Medicare Part A Claims

TriSpan Health Services — the Medicare Part A fiscal intermediary (FI) for Louisiana and Mississippi under subcontract with Blue Cross Blue Shield (BCBS) — is ending its Medicare fee-for-service program administration agreement effective Sept. 30.

Medicare Part A providers who currently bill TriSpan, including those providers not located in Louisiana and Mississippi, should submit their claims to Pinnacle Business Solutions, Inc. (PBSI) beginning Oct. 1.

BCBS assigned the TriSpan Part A subcontract to PBSI until the Centers for Medicare & Medicaid Services (CMS) awards and transitions the work to the Part A/Part B Medicare Administrative Contractor (A/B MAC) for jurisdiction 7 (J7), which includes the states of Louisiana, Mississippi, and Arkansas.

CMS announced July 10 that TrailBlazer had been awarded the A/B MAC contract for J7. On July 20, however, PBSI filed a protest of the award with the Government Accountability Office (GAO). In accordance with the Competition in Contracting Act (CICA), the timely filing of the protest triggered an automatic 100-day stay on performance of the TrailBlazer contract pending GAO’s decision on the bid protest, due Oct. 28.

The following are the current FIs and carriers administering the program in J7 and the states they serve:

  • Cahaba GBA (carrier for Mississippi)
  • PBSI (FI and carrier for Arkansas; carrier for Louisiana)
  • TriSpan (BCBS of Mississippi; FI for Louisiana and Mississippi)
  • Wisconsin Physicians Service Insurance Company (FI for some providers in Arkansas, Louisiana, and Mississippi)

Palmetto GBA is assisting with this transition by providing electronic data interchange (EDI) services and began accepting electronic claims on Aug. 10. This means that all Medicare Part A providers who currently bill TriSpan must submit their electronic claims to Palmetto GBA when the work migrates at the end of September. Note that all new setup requests for EDI transactions received after 4 p.m., Aug. 28, will not be processed until after the migration from TriSpan to PBSI.

TriSpan providers should continue to monitor both TriSpan’s and PBSI’s Web sites for additional transition instructions.

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