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| Attention All CEDI Trading Partners, Suppliers, Billing Services, Clearinghouses, and Vendors National Government Services, Common Electronic Data Interchange (CEDI) is in the process of changing the front-end processes for ANSI X12 837 claims and 276 claim status request transactions. Stage 1 was completed on January 10, 2009 at which time CEDI began performing all front-end edits for ANSI X12 837 claims and 276 claims status request transactions. 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. Stage 2 - Implementation will occur on March 20, 2009* NOTE: The implementation date for Stage 2 was changed from previous communications. · On Friday, March 20, 2009 at 3:00 p.m. ET, the CEDI Gateway will be brought down until Sunday, March 22, 2009 at 6:00 p.m. ET for the DME MACs to remove their front-end edits for 837 claims and 276 claims status transactions. ** During this time, Trading Partners will not be able to connect to CEDI to transmit or receive electronic transactions and/or reports. · The DME MACs will remove their front-end edits and all electronic front-end editing for the X12 837 claims and 276 claim status transactions will be done through CEDI · All 837 claim front-end rejections will be returned on the CEDI GenResponse (GENRPT) report. · 276 claims status request front-end rejections will be returned on the 277 claims status response transaction. · 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 the 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. · All electronic front-end editing for the X12 276 claim status request transaction will be done through CEDI and all front-end rejections will be returned on the 277 transaction. CMN Rejection Report: The process for DME MACs to edit CMNs submitted on the 837 claims will not change. Any CMN rejections will be returned on the CMN Rejection Report produced by the DME MACs and delivered to the Trading Partners CEDI mailbox in the RPT file.NCPDP Claims: NCPDP claims are not affected by these changes. CEDI will continue to receive the NCPDP claims from the Trading Partner and forward the claims to the DME MACs. The DME MACs will perform all front-end editing and assign the Claim Control Number (CCN) to accepted NCPDP claims. Please contact the CEDI Help Desk at 866-311-9184 or by e-mail at ngs.cedihelpdesk@wellpoint.com if you have questions about the upcoming changes or the CEDI front-end edits. All CEDI Listservs are posted to the "News" section of the CEDI Web site at: http://www.ngscedi.com/news/newsindex.htm. |
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