This
communication will apply only to practices that submit claims direct to
TrailBlazer via a dial up modem in the states of Colorado, New Mexico, Oklahoma
and Texas.
If you do not submit claims
in this manner, this communication can be disregarded.
The cutover dates for direct submitters for Part A are
October 29 and November 19.
Direct submitters have the greatest amount of work to do to
prepare for this transition. This
communication will cover:
- What Will Change
- Early Boarding
- Transition Checklist
- Resources
What Will Change
The following will change on the transition dates listed
above:
- The Header information in the claim will
change. To configure, open Revenue
Manager (RM (Activities->Revenue
Management->Revenue Management). From
Revenue Manager (Configure>Receivers. On the EDI receiver for Medicare
(Naming Convention will vary) Select the ‘Header Info’ dropdown box and
update the following fields. Note
that you may have to expand the Window that you are working from.
1.
On the EDI receiver
for Medicare (Naming Convention will vary) Select the ‘Header Info’ dropdown
box and update the following fields:
2.
Receiver ID (ISA08) new payer id for your contractor and jurisdiction
3.
Application Sender
Code (GS02) your Novitas assigned submitter
id
4.
Application
Receiver Code (GS03) new payer id for your
contractor and jurisdiction
5.
Submitter Primary
ID (1000A NM109) your Novitas assigned
submitter id
6.
Receiver Primary ID (1000B NM109) new payer id for your contractor and
jurisdiction
7.
Click on the “Save”
button .
- Your login id and password
will change. For Part A submitters,
you should be receiving from Novitas your new login id and initial
password. Part B submitters will be
receiving their information in October.
- The dial up phone
number. I have not been able to
find the new number in any of the current publications.
To configure, from Revenue Manager (Configure>Communications). More than likely your communication
session is “Trail”. Confirm the
associated communication session from the edit “Receiver” screen.
1.
Find the Communication Session used (Trail, etc”)
2.
Click on the 
details button
3.
Select the “Settings Tab”. Update the “Number field to the new number
(to be determined at this point).
4.
Close the Window above,
then click on “Save”
- The Payer ID will change
for each of the states affected by this transition.
|
PART A JH TRANSITION SEGMENT IV STATE
|
CURRENT CONTRACTOR ID (PAYER ID)
|
NEW JH CONTRACTOR ID (PAYER ID)
|
EFFECTIVE DATE
|
|
|
Colorado
|
04101
|
04111
|
10/29/2012
|
|
|
New Mexico
|
04201
|
04211
|
10/29/2012
|
|
|
Oklahoma
|
04301
|
04311
|
10/29/2012
|
|
|
Texas
|
04401
|
04411
|
10/29/2012
|
|
|
IHS/Tribal Organizations
|
04401
|
04411
|
10/29/2012
|
|
|
Veteran Affairs
|
04401
|
04411
|
10/29/2012
|
|
|
WPS Legacy
|
04901
|
04911
|
10/29/2012
|
|
|
PART B JH TRANSITION SEGMENT V STATE
|
CURRENT
CONTRACTOR ID (PAYER ID)
|
NEW JH CONTRACTOR ID (PAYER ID)
|
EFFECTIVE DATE
|
|
Colorado
|
04102
|
04112
|
11/19/2012
|
|
New Mexico
|
04202
|
04212
|
11/19/2012
|
|
Oklahoma
|
04302
|
04312
|
11/19/2012
|
|
Texas
|
04402
|
04412
|
11/19/2012
|
|
IHS/Tribal Organizations
|
04402
|
04412
|
11/19/2012
|
|
Veteran Affairs
|
04402
|
04412
|
11/19/2012 |
The Payer ID in Medisoft can be changed by going to Lists>Insurance>Carriers. Locate your Medicare carrier and double click
on it. Click on the “EDI/Eligibility”
tab.
- It is recommended you send
minimum 25 test claims. There is a
specific process for testing so we recommend you seek assistance for the
testing. We can then make the
changes needed to submit a successful test.
Early
Boarding
The ability to transition to SmartXfr™, the
Novitas Solutions’ version 5010 telecommunications server, prior to the cutover
date, is an effective option called “early boarding,”. Novitas Solutions will
establish the interfaces to the TrailBlazer claims processing system, and all
electronic claims submitted to Novitas Solutions will be processed just as if
they were submitted to the TrailBlazer front-end system.
In September for Part A and
October for Part B, an early boarding information letter will be mailed to
transitioning submitters. This letter will also include your new Novitas
Solutions login ID and the date you can begin early boarding. You will need to
use your current active TrailBlazer submitter ID and new Novitas Solutions
login ID to access the SmartXfr™ telecommunications server.
By the designated production cutover dates, all providers
must be transitioned to Novitas Solutions. We strongly encourage all impacted
providers to make the necessary changes and begin performing all EDI activity
with Novitas Solutions during the early boarding period. There is no need to
test with Novitas Solutions’ EDI Services if you are already submitting claims
electronically to TrailBlazer. We do, however, encourage you to validate
your connectivity to SmartXfr™ using your current active submitter ID and new
Novitas Solutions login ID to ensure you can successfully submit claims and
receive/retrieve EDI reports electronically.
During the early boarding period, you will continue to
submit the current TrailBlazer contractor ID (payer ID). Electronic claim
files submitted to Novitas Solutions will be forwarded to TrailBlazer for
processing during the transition period. Our goal is to ensure that there is no
disruption of claims processing, so claims received by 5:00PM CT will be
entered in the current day’s cycle. Novitas Solutions will provide reports and notifications
regarding those submissions to you via your SmartXfr™ electronic mailbox.
Please contact
us if you want assistance in making the changes in your system and setting up
the Early Boarding process.
Transition Checklist
Following is a
check list for a smooth transition for clients submitting direct claims.
|
Action
|
Due Date
|
Required Action
|
|
Check the Novitas Solutions
Transition Homepage Frequently
|
Ongoing
|
The Web site is frequently
updated and is the repository for information about the transition.
|
|
Create Internal Project Plan
|
Ongoing
|
Include business partner
activities as well as those internal to your operation. Don¡¦t overlook job
aids and staff training.
|
|
Hold Checkpoint/Status Meeting
Regularly to Review Readiness
|
Ongoing
|
Review progress and scan for
issues.
|
|
Verify your Current Electronic
Billing Arrangement
|
Now
|
Determine if you are managing
your billing directly or are using external agents such as clearinghouses and
billing services (aka. ¡§vendors¡¨).
|
|
Notify/Confirm Internal Staff
Vendor Awareness of the Transition
|
Now
|
Confirm those responsible for
managing the EDI exchange are aware of the transition; the Novitas Solutions
Web site; and are positioned to receive Listserv notifications.
|
|
Read the
SmartXfr. Connectivity Guide
|
Now
|
This guide contains important
information you will need to connect to SmartXfr
|
|
Read
the SmartXdr Companion Guide
|
Now
|
This guide contains important
information you will need for billing electronically to Novitas Solutions.
|
|
View
th Part A Training Modules
|
Now
|
The training modules provide
beneficial instructions and information on EDI reports generated by Novitas
Solutions.
|
|
View
Part B Training Modules
|
Now
|
The training modules provide
beneficial instructions and information on EDI reports generated by Novitas
Solutions.
|
|
Novitas Solutions will Issue New
Login ID
|
Week of September 10 for Part A
Week of October 1 for Part B
|
After receiving your new login
ID, setup systems for SmartXfr connection
|
|
Setup Systems to Connect to
SmartXfr
|
Novitas Solutions¡¦ Telecommunications
Server "
|
Starting September 17 for Part A
Starting October 8 for Part B |
|
Conduct Connectivity
Testing After receiving the new
Novitas Solutions login ID
|
Starting September 17 for Part A
Starting October 8 for Part B
|
Confirm ability to connect with
SmartXfr and successfully submit electronic claims and retrieve electronic
reports from Novitas Solutions. Read the article on page 4 for information on
connectivity testing. "
|
|
Discontinue Sending Production
Files to TrailBlazer and Send Production Files to Novitas Solutions
|
October 26 for Part A November
16 for Part B
|
Cease sending files to
TrailBlazer after this date and the specific time to be announced in the
Cutover Notice.
|
|
Direct EDI Transactions to
Novitas Solutions
|
October 26 for Part A November
16 for Part B
|
Begin to use Novitas Solutions¡¦
telecommunications platform; availability will be announced in the Cutover
Notice.
|
|
Change Contractor ID (Payer ID)
Prior to Submitting Production Claims to Novitas Solutions
|
October 29 for Part A November
19 for Part B
|
New contractor ID (payer ID)
must be added before sending your first production file. Refer to the New
Contractor ID (Payer ID) article on page 5 for more details.
|
Resources
Following are
phone numbers and links for helpful resources to help you transition to Novitas
Solutions.
MD Solutions
Support: 303-273-0141
Toll Free
866-273-0141
e-mail” helpdesk@mdsco.com
Novitas EDI
Help Line: 888-541-3827
TrailBlazer
EDI Help Line: 866-749-4302
Link To
Resource For This Communication: https://www.novitas-solutions.com/transition/jh/edi/pdf/sipp-4-5-0812.pdf
NOTE: Some of the updates listed
above are technical in nature, and if not done correctly could affect your
claims. If you have any doubts as to
whether you can update on your own, please call MD Solutions for an appointment. Normal Support terms will apply.
If you have any questions regarding this information please
e-mail us at helpdesk@mdsco.com
