EDI Support Services

E-mail Distribution

September 1, 2009

Electronic Data Interchange Support Services (EDISS) sends E-mail Distributions to subscribers wishing to receive the latest Electronic Data Interchange (EDI) updates. Direct all questions regarding the content of this E-mail to EDISS. Contact information is provided at the bottom of this document. Do not reply to this E-mail.

Total OnBoarding Medicare B Implementation Final Notice

For All Medicare Part B Providers and Trading Partners 

September 4, 2009 is the cut-off date for acceptance of Medicare Part B paperwork by EDI Support Services (EDISS). After September 4, 2009 any paper registration received will be rejected and not processed. All registration is to be conducted through the Total OnBoarding system. New providers will still be required to submit the applicable enrollment form for their line of business.

On June 1, 2009, EDISS implemented Total OnBoarding (TOB) for all Medicare Part B providers. TOB is a user-friendly online registration and testing tool, replacing the current paper registration and claim testing process.

For any Trading Partner unfamiliar with Total OnBoarding, EDISS is pleased to offer the following TOB workshop during the month of September:

Getting Started with EDISS and Total OnBoarding (TOB)

09/22/2009 Register Now!

3:00 p.m. (CT)

Begin your online enrollment today by clicking on the following link: Total Onboarding - Login. 

Healthcare Provider Taxonomy Codes Update October 2009 (CR6598)

For All Medicare Trading Partners 

The Healthcare Provider Taxonomy Codes (HPTC) set is maintained by the National Uniform Claim Committee (NUCC) for standardized classification of health care providers. The NUCC updates the code set twice a year with changes effective April 1 and October 1.

The HPTC list is available from the Washington Publishing Company (WPC) (http://www.wpc-edi.com/codes/taxonomy) in two forms. The first form is a free Adobe PDF download. The second form, available for purchase, is an electronic representation of the code set that facilitates automatic loading of the codes.

HIPAA requires covered entities comply with the requirements in the electronic transaction format implementation guides adopted as national standards. The institutional and professional claim electronic standard implementation guides (X12 837-I and 837-P) require use of valid codes contained in the HPTC set when there is a need to report provider type or physician, practitioner, or supplier specialty for a claim. Valid HPTCs are those codes approved by the NUCC for current use. Terminated codes are not approved for use after a specific date. Newly approved codes are not approved for use prior to the effective date of the code set update in which each new code first appears.

Although the NUCC generally posts their updates on the WPC Web page 3 months prior to the effective date, changes are not effective until April 1 or October 1 as indicated in each update. Specialty and/or provider type codes issued by any entity other than the NUCC are not valid, and Medicare would be guilty of non-compliance with HIPAA if Medicare contractors accepted claims that contain invalid HPTCs.

September Online Workshop Schedule Reminder

For All Trading Partners  

EDISS still has open spots available for the following online workshops during the month of September:

PC-ACE Pro32 101	09/10/2009 Register Now!	10:00 a.m. (CT)
Getting Started with EDISS and Total OnBoarding (TOB)	09/22/2009 Register Now!	3:00 p.m. (CT)

Top Five Telephone Inquiries and Solutions for August 2009

For All Trading Partners 

EDI Support Services (EDISS) would like to provide solutions to the “Top Five” telephone inquiries our EDISS Help Desk received in August 2009. The EDISS website (www.edissweb.com) also contains excellent information to assist with customer inquiries.

For all inquiries to the EDISS Help Desk, please have the provider’s billing NPI number ready for the Customer Service Specialist that answers your call. The Tax ID or Submitter ID is also helpful if available.

1.      Total OnBoarding (TOB)

TOB is a user-friendly online registration and testing tool, replacing the current paper registration and claim testing process. The use of TOB is required for all electronic providers.

There is a Total OnBoarding tab that is accessible from the main page of www.edissweb.com. This tab will take you to our TOB page where you can find our TOB User Guides and a direct link to the TOB login page. Once you browse to the TOB login page, feel free to add it under your favorites or bookmark it.

EDISS also offers monthly online workshops on Getting Started with Total OnBoarding and EDISS. Visit the Training and Help page of our website if you wish to register for a future session.

The News and Publications tab on www.edissweb.com also contains TOB related articles and newsletters. EDISS encourages any provider with questions to review this page for answers. If you are unable to find needed information regarding TOB, please feel free to contact our help desk at 877-269-1472. You may also email us at support@edissweb.com.

2.      Assistance reading and understanding EDISS reports

Reports generated by the EDISS front-end collection system are a vital part of following the status of claims as they process through EDISS and onto the processing floor for possible payment. Providers who do not review their reports will be at a distinct disadvantage in knowing the status of their claims. Not viewing reports may lead to confusion on claim counts or smaller then expected payments. EDISS provides detailed instructions on each EDISS report under the Report Documentation section on the Training and Help page of www.edissweb.com.

EDISS offers periodic workshops on Understanding EDISS Reports. To view the entire EDISS workshop schedule, or to view previous workshop minutes, refer to the Schedule link under the Workshop section of the Training and Help page of www.edissweb.com.

3.      Password Resets

As required by the Centers for Medicare & Medicaid Services (CMS), EDISS suspends user accounts and requires administrative reset by the EDISS Help Desk after three failed login attempts and/or after 30 days of inactivity.

To avoid administrative reset:

·        Log into your account once every 30 days to keep it in an active status.

·        If necessary, write your password down. If you do need to write it down, keep it in a secure location.

EDISS requires new users to change their password upon initial login, and all users must change their password every 60 days. When creating a new password it is important to note the following criteria:

·        Password must be exactly 8 characters in length.

·        Password must include a number, letter, and one special character (such as *, &, #).

·        The use of dictionary names or words as passwords is prohibited.

·        The same password cannot be reused for 6 generations (1 year).

The EDISS website, www.edissweb.com contains documentation under the User Documentation, Bulletin Board System section of the Training and Help page. To view the document, click on the link called “Changing Password in EDISS' BBS”.

NOTE: With the introduction of Total OnBoarding (TOB) the BBS will only be used for production claim activity. All testing is completed through the TOB system.

4.      Electronic Remittance Advice

Electronic Remittance Advice (ERA) are delivered to the Bulletin Board System (BBS), and are available to Trading Partners set up with the 835 transaction via their electronic mailbox. After delivery, they are available for downloading for 40 days. Within this 40-day timeframe, Trading Partners have the option of re-downloading an advice at any time. After 40 days, they are archived and are not accessible through the BBS.

For instructions on downloading electronic remittance via the EDISS BBS, refer to the User Documentation section on the Training and Help page of www.edissweb.com.

5.      Delivery of EDISS reports

EDISS delivers a series of reports based on claim submissions from providers. Reports are located on the Bulletin Board System (BBS), and are available for download by Trading Partners via their electronic mailbox for 40 days. Within this 40-day timeframe, Trading Partners have the option of re-downloading a report at any time. After 40 days, they are archived and are not accessible through the BBS. If you use a Billing Service or Clearinghouse to submit your claims to EDISS, please check with this vendor to determine the delivery of your report.

For instructions on downloading reports via the EDISS BBS, refer to the User Documentation section on the Training and Help page of www.edissweb.com.

NOTE: With the introduction of Total OnBoarding (TOB) reports generate from production claim activity only. Information on testing claim submission is acquired through functionality in TOB.

EDISS sends out this distribution. If there are any questions regarding the content of this distribution contact EDISS.

Some of the provider information contained on the EDISS e-mail distribution is copyrighted by the American Medical Association and the American Dental Association. This includes items such as CPT codes and CDT codes.

Information contained within this distribution is not intended to be republished or shared with Trading Partners who are not customers of EDI Support Services. Any unauthorized use, disclosure, distribution or copying is prohibited.

Due to different e-mail settings, attachments may appear with this e-mail. Please ignore any attachments that are included with this e-mail.

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