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Thursday, November 13, 2008

Fwd: How to Resolve the 20011, 20004, and B108 Front-End Rejections

Common Electronic Data Interchange (CEDI) Electronic Trading Partners receiving the 20011, 20004 or B108 rejections, should review the information below to determine how to resolve these edits.
 
 20011 Rejection:
These rejections are returned on the Level II reports created by the DME MACs and delivered by CEDI. 
 
To correct the front-end rejection error code of 20011, suppliers can either:
§      Submit the online EDI Enrollment Form to CEDI at www.ngscedi.com. CEDI will then setup the supplier with the ability to send electronic transactions in all four DME MACs
OR
§      Submit an e-mail to CEDI Enrollment using the following instructions:
§      Send an e-mail to: cedienrollment@wellpoint.com
§      Subject line should read: Edit 20011 Resolution
§      Provide the following within the e-mail:
§      Submitter (Trading Partner) ID
§      Submitter (Trading Partner) Name, Address, City, State, ZIP
§      NSC/PTAN AND NPI numbers that received this error
§      Contact Name
§      Contact Phone Number
 
All CEDI enrollment forms can be found under the EDI Enrollment section of the CEDI Web site (www.ngscedi.com).
 
NOTE:  Requests submitted online with CEDI or through e-mail requests are processed in the same timeframe. Do not submit both the online form and an e-mail request. This could delay the processing time of your setup.
 
 20004 Rejection:
These rejections are returned on the Level II reports created by the DME MACs and delivered by CEDI. 
 
To correct the front-end rejection error code of 20004, suppliers can either:
§      Submit the online Submitter Action Request Form to CEDI at www.ngscedi.com.  CEDI will setup the Trading Partner/Submitter ID with the ability to send and receive electronic transactions to all four DME MACs.
OR
§      Submit an e-mail to CEDI Enrollment using the following instructions:
§      Send an e-mail to: cedienrollment@wellpoint.com
§      Subject line should read:  Edit 20004 Resolution
§      Provide the following within the e-mail:
§      Submitter (Trading Partner) ID
§      Submitter (Trading Partner) Name, Address, City, State, ZIP
§      Contact Name
§      Contact Phone Number
 
All CEDI enrollment forms can be found under the EDI Enrollment section of the CEDI Web site www.ngscedi.com.
 
NOTE:  Requests submitted online with CEDI or through e-mail requests are processed in the same timeframe. Do not submit both the online form and an e-mail request. This could delay the processing time of your setup.
 
 B108 Rejection:
These rejections are returned on the GenResponse (GENRPT) reports created and delivered by CEDI. 
The CEDI provided a B108 warning message on the CEDI GenResponse (GENRPT) Report when the NPI was not linked to the Trading Partner (Submitter) ID. Prior to October 1, 2008, this was a warning message and the submitted claims did not reject. Accepted claims with the B108 warning message were being forwarded to the appropriate DMEMAC.
The CEDI edit B108 changed from a warning to a rejection on October 1, 2008. Claims that do not have an NPI matched to the Trading Partner (Submitter) ID are now being rejected by CEDI and not forwarded to the DME MACs.
If the B108 error is received, the supplier must complete and sign the appropriate form on the CEDI Web site www.ngscedi.com and return to CEDI for processing.
§      Suppliers using a third party (e.g., a clearinghouse or billing service) must complete the Supplier Authorization Form Note: The Supplier Authorization Form cannot be signed by a third party. This form MUST be signed by the supplier.
§      Suppliers who submit their own claims and do not use a third party biller must complete the CMSEDI Enrollment Agreement.
The CEDI Enrollment Team is processing all enrollment requests in the order they are received and will respond once your setup is complete. 



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