| NHIC, Corp.DME MAC A ListServe | For Imediate Release |
November 13, 2008
Update on the CEDI Front-End Editing Process
National Government Services, Common Electronic Data Interchange (CEDI) is in the process of changing the current front-end editing process. It was previously educated that changes would be made on October 6th and in Mid-November. The dates originally communicated have been moved back to the beginning of 2009. The exact dates will be provided via the CEDI Listserv, as soon as they are available.
The changes to the front-end editing process will occur in stages.
First set of changes (Stage 1) include:
- Additional front-end edits will be added to the current CEDI GenResponse (GENRPT) report. All new edits have been added to the CEDI Front-End Reports Manual. This manual is available on the CEDI Web site at: http://www.ngscedi.com/outreach_materials/outreachindex.htm
NOTE: As a reminder, the following edits were added to the GenResponse Report on October 6, 2008:
| NGS005 | C007 | C065 | C087 | C125 | C143 |
| NGS006 | C015 | C072 | C088 | C131 | C147 |
| NGS008 | C055 | C077 | C089 | C137 | C154 |
| B108 | C060 | C086 | C090 | C141 |
- Claims accepted on the CEDI GenResponse Report will be delivered to the appropriate DME MAC.
- Claims delivered to the DME MAC will continue to edit against the DME MAC Level II edits as they do currently.
- Claims accepted on the DME MAC Level II reports will be assigned a Claim Control Number (CCN) that will be attached to the claim as it enters the DME MAC for processing.
- Level II reports created by the DME MACs will continue to be delivered back to the Trading Partners through CEDI.
- Most, if not all, claims that reject will be returned on the GenResponse Report. It will be extremely important for Trading Partners to monitor the GenResponse Report for rejected claims in order to correct and resubmit the claims to CEDI.
Second set of changes (Stage 2) include:
- All electronic front-end claim editing will be done through CEDI and all front-end rejections will be returned on the CEDI GenResponse (GENRPT) report.
- The additional GenResponse edits that were implemented in Stage 1 will replace the DME MAC Level II edits and Trading Partners will no longer receive Level II reports from the DME MACs.
- Claims accepted on the GenResponse Report will be assigned a Claim Control Number (CCN) and these will be indicated on a report that will go back to the Trading Partner from CEDI. This CCN will be attached to the claim as it enters the appropriate DME MAC for processing.
- DME MACs will continue to produce the CMN Rejection Report and it will be returned to the Trading Partners through CEDI.
NOTE: The process changes included in Stage 2 may be broken down into additional stages. As the dates for these changes are finalized, notification will be sent via the CEDI listserv.
All CEDI Listserves are posted to the "News" section of the CEDI Web site at: http://www.ngscedi.com/news/newsindex.htm
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