Is anyone getting paid by Noridian Medicare?

mmaclachlan

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Since January 1st we have had a series of electronic rejections on our Noridian Medicare claims. First the clearinghouse thought it was a credentialing issue but finally decided it is a mapping issue that was created with the switch to 5010. A few claims are getting through but most are not. Reimbursment has dropped significantly in 2012. We have been told by our software vendor that this is a known issue and are stuck waiting until Noridian/Emdeon figure it out. Is anyone else having similiar issues?

Michele MacLachlan
 

Herbie Lorona

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I haven't received many rejections from them but they payments haven't seemed to come in as quickly as they normal do.
 

LilMissCoder

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We also use Emdeon and yes, there is a problem with the mapping that is effecting us as well. I spent a long time on the phone yesterday trying to get it straightened out but I'm unsure that I actually managed to do it. We're not getting rejections from Noridian on paper, the claims are sitting in Emdeon rejected for a loop error that is putting the wrong information in box 33 even though we are uploading the correct info.

Its beyond fustrating!
 

Herbie Lorona

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You might need to speak with your software vendor about that error Tracy. They should know what loops are getting pulled into what boxes. We have had similar errors for loop information and the vendor was able to help me get that figured out.
 

mmaclachlan

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We got an update on Thursday (2/16) from our software vendor (Vitera/Sage) saying the issue has been resolved with Emdeon. They told us to resubmit all Medicare claims during the timeframe which started on 12/14/11. If any reject again, we may need to complete some registration paperwork with Emdeon but to still start with a rebill. I cleared all my electronic rejects and rebilled everything on Friday morning. Fingers are crossed that they all go through because if they reject again, I think I will pull my hair out!
 

mmaclachlan

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Pulling my hair out!

:mad:

Everything rejected! Put in another service request with Vitera/Sage. Faxing all my approval emails from EDISS to Emdeon for them to re-link my providers. This is really hurting our business. Medicare is our second largest payer.
 

Herbie Lorona

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:mad:

Everything rejected! Put in another service request with Vitera/Sage. Faxing all my approval emails from EDISS to Emdeon for them to re-link my providers. This is really hurting our business. Medicare is our second largest payer.

So what is the rejection reason say?
 

mmpratt

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Noridian rejections

We also had batch after batch of claims rejected, all with denial remark MA75. Finally discovered that this had to do with release of information on claims. We had 'informed consent to release ...' as our default reason on the system level. Medicare no longer accepts this. So we changed our default to 'permanent signed release...' and had to rebill all claims.

Medicare sent out something about this on a listserve message I received Tuesday morning, 2/21/12. It has to do "'I' now being invalid and 'P' the only accepted value."

Hope this helps.
 

mmaclachlan

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Update

Herbie - the error is "Information submitted inconsistent with billing guidelines. - Rendering Provider"

Medicare issued an alert on Tuesday saying the mapping issue is with the clearinghouses and not the MACs. https://www.noridianmedicare.com/cgi-bin/coranto/viewnews.cgi?id=EFFpEpyEZFmieMcaxe&tmpl=part_b_viewnews&style=part_ab_viewnews

I spoke with my software vendor on Tuesday and they were told on Tuesday that Emdeon has accepted responsibility for the errors and is working on a resolution. Yesterday I had a message from my vendor saying Emdeon hopes to have a solution today and will let us know if we have to resubmit everything or if they will reprocess.
 
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