Highmark Medicare Services hosted a Part A Ask the Contractor teleconference on September 3, 2008.  A portion of the questions asked were specifically related to the transition of the New Jersey Part A providers.  Answers to those questions are provided below:

1.  When accessing FISS, one person in our office has access to options 1-4, while another person in our office has options 1-9.  Which is correct? 

 When accessing FISS for Direct Data Entry (DDE), users should receive a menu containing list of options 1 - 4.  A system error occurred at the Enterprise Data Center (EDC) during the transition of logon IDs from Riverbend to Highmark Medicare Services that causes some users to receive a menu containing a list of options 1 - 9 instead of a menu containing a list of options 1 - 4.  We are aware of this issue and are working with the EDC for a resolution to correct all incorrect logon IDs.  If you access FISS for DDE and the menu displays options 1 - 9 instead of 1 - 4, please call the Customer Contact Center at 1-877-235-8048 and report that your FISS/DDE ID has the incorrect options.  We will subsequently notify the EDC to correct your ID on an individual basis until such time that the root cause of the problem is corrected.

2.  Do we pull remittances the same way as we did under Riverbend?

The process to connect to the EDI Front-End Platform, known as the Stratus Telecommunication Server, at Highmark Medicare Services to transmit claims and retrieve electronic reports, including the Electronic Remittance Advice, is a different process from that used by your previous Medicare Contractor.  Your new Submitter ID and Login ID, along with a customer-controlled password, will be required to connect to your new EDI mailbox on the Stratus Telecommunication Server.  To retrieve your EDI reports and ERA from Stratus, use the menu option associated to the EDI report/ERA.  Please refer to the "Transmission Bulletin Board Menu" section of the "Transmission Bulletin Board Menu for the Stratus EDI Platform" article on page 11 of the August 2008 EDI Transition News for details.  

3  We adjusted claims originally processed under our legacy number; we received the adjustment under the NPI, but did not receive the remittance with the retraction under the legacy or NPI.  How do we get retrieve these remittances?

The Electronic Remittance Advice (ERA), including "no-pay" ERAs, are generated using the NPI; however, the legacy ID must be cross walked to the NPI.  This would include all claims, including adjustment claims and any claims that are adjudicated and result in no payment being issued.  If adjusted claims or claims that result in no payment do not appear on your ERA, please consult with your software vendor, billing service, and/or clearinghouse to ensure you are set-up to receive adjusted claims and claims that result in no payment (as sometimes it may be suppressed). 

4.  When I am trying to access FISS, the user ID field is indicating that I’m not authorized and the password field is blank.  What can I do to obtain access?

If you are attempting to access FISS and are having logon issues, your user ID may have been deleted due to inactivity or it may not have been provided to Highmark Medicare Services by Riverbend.  If you receive this error, please refer to the management of FISS logons on our Internet site or call the Customer Contact Center at 1-877-235-8048 for assistance.

If you receive password violation or your user ID was revoked because of password violations, refer to the self-service password reset instructions.  Should you require further assistance resetting your password, please contact the Customer Contact Center at 1-877-235-8048.

5.  I am trying to access FISS.  My password was reset, but the screen is indicating that the transaction was not recognized.  What should I do?

During the transition weekend, the Enterprise Data Center deleted numerous logon IDs for FISS.  Highmark Medicare Services requested these IDs to be reinstated on 09/03/2008.  As a result of this process, the reinstated user IDs were reset to a default password, which will then prompt users to set a new password.  Please refer to the password reset instructions and the RACF ID and Password Rules for instructions.  Should you require further assistance resetting your password, please contact the Customer Contact Center at 1-877-235-8048.

6.  If I need to retrieve a remittance advice that was generated by Riverbend, what do I need to do?

For Standard Paper Remittances (SPRs), including those prior to September 3, contact Highmark Medicare Services' Provider Customer Contact Center at 1-877-235-8048.

Riverbend NJ Part A will recreate and issue Electronic Remittance Advice (ERA) for their former customers for 45 days from the transition date to Highmark Medicare Services.  After that date, ERAs originally created by Riverbend will no longer be available from Riverbend or Highmark Medicare Services.  NJ Part A providers who need an ERA recreated for September 3, 2008, or prior should call Riverbend eBusiness Services at 423-535-5717.

7.  I was told that we could use NewPA$$1 for user name and password for all of our users’ access. Is this correct?  

During the transition weekend, the Enterprise Data Center deleted numerous logon IDs for FISS.  Highmark Medicare Services requested these IDs to be reinstated on 09/03/2008.  As a result of this process, the reinstated user IDs were reset to a default password, which will then prompt users to set a new password.  Please refer to the password reset instructions and the RACF ID and Password Rules for instructions.  If you receive password violation or your user ID was revoked because of password violations, refer to the self-service password reset instructions.  Should you require further assistance resetting your password, please contact the Customer Contact Center at 1-877-235-8048.

For connectivity difficulty, please contact your Secure Direct Data Entry (DDE) Vendor. 

8.  When I called the Provider Contact Center and accessed the IVR, I was asked- What state are your claims processed?  I indicated Pennsylvania (although my facility is in New Jersey).  I was advised that I should have answered New Jersey.  This is confusing. Can the question be reworded? 

Thank you for your feedback regarding the IVR.  We are currently assessing the message for added clarity.  When calling the IVR, users must currently select the contract for which the claims are processed.  To identify which contract is correct for your organization if you are unsure, you can refer to the FISS region you log on to for DDE or the contractor ID that you report in your X12N 837 claim file. Please see the What's New posted on September 10, 2008 for more information.

9.  Can both tabs on Pro 32 1.92 for professional and institutional claims be utilized?

Highmark Medicare Services offers PC-ACE Pro32 for Institutional Claims to our Part A customers in Pennsylvania, Maryland, the District of Columbia, and New Jersey.  We also offer PC-ACE Pro32 for Professional Claims to our Part B customers in Maryland, the District of Columbia Metropolitan Area, and Delaware.  Highmark Medicare Services currently offers Medicare Claims Express (MCE) for Professional Claims to our Part B customers in Pennsylvania and New Jersey.  PC-ACE Pro32 will be made available at a future date to our Part B customers in Pennsylvania and New Jersey.  Please watch our website and EDI publications for information on the migration from MCE to PC-ACE Pro32 as details become available.

Therefore, EDI customers in Maryland and the District of Columbia (DC Metro Area) who bill for both Part A and Part B services may use PC-ACE Pro32 to submit both professional and institutional claims; however, you must first be enrolled with Highmark Medicare Services to use PC-ACE for both Part A and Part B.  For example, if a Maryland provider is enrolled for PC-ACE Pro32 to submit Part A claims and would now like to use PC-ACE to also submit their Part B claims, then the Maryland provider would need to complete a PC-ACE Enrollment Form for Part B in order to use the software to submit Part B claims.  All EDI-related enrollment forms can be located on our website.

To provide the most up-to-date information within PC-ACE Pro32, the product is updated quarterly. The most recent upgrade to PC-ACE Pro32 version 1.94 was released by Highmark Medicare Services on July 31, 2008.  Existing PC-ACE Pro32 customers were sent a letter with download instructions.  Our New Jersey Part A customers will receive a letter in mid-September that contains PC-ACE Pro32 download instructions for version 1.94. CMS requires that upgrades be installed within 90 days of receipt. 

10.  I am unable to log-on to FISS what do I need to do?

If you are attempting to access FISS and are having logon issues, your user ID may have been deleted due to inactivity or it may not have been provided to Highmark Medicare Services by Riverbend.  If you receive this error, please refer to the management of FISS logons on our Internet site.  If you receive password violation or your user ID was revoked because of password violations, refer to the self-service password reset instructions.  Should you require further assistance resetting your password, please contact the Customer Contact Center at 1-877-235-8048