Part B Insider (Multispecialty) Coding Alert
This MAC Is Rejecting Claims Via EDI
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Plus: Your email could get you into HIPAA trouble
If you’ve recently started using the electronic data interchange (EDI)—or even if it’s old hat to you—your payer might be experiencing issues when it comes to processing those EDI claims.
National Government Services, a Part B Payer, released an email blast notification on Oct. 30 indicating that the October 2013 Quarterly Release included an update that verified eligibility for incoming claims. Unfortunately, the update appears to have caused more issues than it fixed.
“This new method has caused errors such as not recognizing spacing, punctuation, and characters in a beneficiary’s name,” NGS said in the email. “As a result, claims are rejecting.”
If you are one of the unlucky practices impacted by this update, know that CMS has allowed NGS to hold the impacted claims until a resolution is discovered. Once the technical bug is fixed, NGS will do a mass adjustment to reprocess claims. Therefore, you needn’t resubmit those claims to NGS.
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