Saturday, November 15, 2008

New Jersey Medicare transitioning to Highmark Medicare Services November 14

Payor agreements are required for electronic claims to CPID# 1465 New Jersey Medicare as they switch contractors.

Providers already approved to submit claims through RelayHealth are not required to complete an agreement.

New providers are required to complete an agreement.

Original Notification Sent on November 11, 2008: RelayHealth will be converting CPID 1465 New Jersey Medicare from National Government Services (NGS) to Highmark Medicare Services effective November 14, 2008.

Special requirements:
RelayHealth will be converting the existing Contractor ID 00805 to the new J12 Contractor ID 12402 on November 14, 2008.
Highmark Medicare Services will observes system dark days November 15, 2008 through November 17, 2008.

  1. There will be no access to the MCS processing system, claim entry or claim corrections, and verify beneficiary eligibility and claim status as well as limited EDI processing.
  2. Claims sent to Highmark Medicare Services between 4:00 PM on Friday November 15, 2008 and 4:00 PM on Monday November 17, 2008 will process on Monday night November 17, 2008. EDI report and ERA files will be available Tuesday November 18, 2008.
  3. First payment cycle will take place on Monday night November 17, 2008. Checks and EFTs created will be dated November 18, 2008.
  4. Customer Contact Center and IVR availability will not be available until Tuesday, November 18, 2008.

RelayHealth has identified the following items for you to be aware of with this change:

  • Payor agreements are not required for electronic claims.
  • Payor agreements are required for electronic remittance.

*Providers already approved to receive remittance through RelayHealth are not required to complete an agreement.
*New providers are required to complete an agreement.

  • The following payor reports will be available
    *Batch Detail Control Listing
    *Provider Summary Report & RelayHealth Standardized Payor reports for the above payor will be available as soon as possible after November 18, 2008

Additional Medical Billing and Codingquestions are answered here: Online Medical Coding and Billing Courses

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