Patient Statement Issue

Tuesday, Nov 11, 2008 - 02:36:11 PM

Update 11/12: This issue has been resolved.

Kareo is currently experiencing technical problems with the patient statement system.   At this time we ask that you do not attempt to submit any patient statement batches.  Our team is working to resolve the issue as soon as possible.

We apologize for the inconvenience.

WellCare Erroneous INS messages Payer ID: 14163

Monday, Oct 6, 2008 - 04:27:09 PM

Important Message from MedAvant

Date Range: 07/14/2008 to 09/04/2008

Details:

Medavant has received the notification below from this payer: 

WellCare has identified a problem in their processing that resulted in a delay in some claims submitted from July 14 through September 4th that may have been rejected by WellCare without rejection information. The error message reads:

R - NA - Due to invalid information on other claim(s) the entire batch was rejected. Please correct invalid data and resubmit claim (s) electronically. ; LOOP: NA, SEG: NA, FIELD: NA

Wellcare sincerely apologizes for their processing error and any inconvenience it has caused
We sincerely apologize for the inconvenience

Submitter Actions: Submitters should RESUBMIT any claim that has not yet been paid. 

Notification ID: 20081002-01

Patient Statement Issue

Wednesday, Aug 27, 2008 - 10:10:31 AM

Kareo is currently experiencing technical problems with the patient statement system.   At this time we ask that you do not attempt to submit any patient statement batches.  Our team is working to resolve the issue as soon as possible.

We apologize for the inconvenience.

Erroneous Acknowledgement Message

Thursday, Jul 31, 2008 - 08:15:37 AM

Important Message from MedAvant

Date Range: 7/29/2008 to Present

Details:

We received the following erroneous message from various payers:

Entity does not meet dependent or student qualification.; Entity not eligible for medical benefits for submitted dates of service

The message was issued in error. Our preliminary research indicates that the claims have been accepted.

Submitter Actions:  None

Notification ID: 20080730-02

NPI Errors with Humana claims, Payer ID’s 61101, 61102, 00034, 00207, 58226, 73288 and 95885

Wednesday, Jul 30, 2008 - 06:32:00 PM

Important Message from MedAvant

Date Range:  07/23/08 – 07/25/08

Details:

Effective 07/23/08, Humana turned on an edit requiring NPI only in all provider fields/loops.  This edit included rejecting the existence of any legacy id including tax ID and SSN in any provider fields/loops other than the Billing or PayTo.

This caused an increased volume in rejects at the payer.  Humana removed this edit the night of 07/28/08 and reverted back to the requirements of 07/22/08, where Humana requires NPI in all provider fields/loops.

Submitter Actions:  No action required, MedAvant will resubmit all files from 7/23/08 to 7/25/08 today.  Please carefully monitor your responses from both MedAvant and Humana. Per Humana’s requirements please make sure that NPI is included in all provider fields/loops.

Notification ID:  20080730-04

Legacy IDs Required for Payer IDs MC009, CCHP9 and CCHP1

Monday, Jul 28, 2008 - 03:43:25 PM

Important Message from MedAvant


Date Range: Effective Immediately

Details:

The payers listed below are still requiring Legacy ID’s to be sent on claims, NPI will be accepted, but the Legacy IDs must be present.

MC009 – Illinois Medicaid
CCHP9 – Cooks Children’s Hospital
CCHP1 - CHIPS

Submitter Actions:  Please include you legacy id on claims submitted for these payers.

Notification ID: 20080728-01

Florida Medicaid ERA’s (MC010)

Friday, Jul 25, 2008 - 09:06:20 AM

Important Message from MedAvant

Date Range: June 23rd - Present

Details:

As Florida Medicaid transitioned their transaction processing from ACS to EDS on June 23rd, clients that were receiving ERAs from Florida Medicaid will have to perform the following steps in order to allow Florida Medicaid to send the provider’s ERAs to MedAvant:

Step 1: Access the payer’s portal at https://home.flmmis.com: Initially, when each provider enrolled with Florida Medicaid to receive a Provider ID, they were given access to this payer portal with a specific login and password.  If the provider no longer has their access information, please contact Florida Medicaid to retrieve this information by calling 800-289-7799 and selecting Option 5 to get to Provider Services. Once logged in, you will need to select Account Management (see screen shot below)

Step 2: Add MedAvant as an Agent.  Once the client has reached the Account Home, they will need to click on Add Agent at the top of the screen (see first screen shot below).  This will then bring the provider to the Add Agent screen (see second screen shot below).  The client will then enter the E-mail address linked to MedAvant which is: Payer.Advocacy@MedAvanthealth.com.  Please note that this E-mail address is not one in which the provider should use for any E-mail communications to MedAvant as it will not be monitored.  Once the E-mail address has been entered, click Search and MedAvant will be listed as an Agent.  The provider will then need to click on Manage Agent.

Step 3: Modify Agent to allow for 835 Download: The next screen to show up will allow you to modify setting for the agent on the portal.  The provider will need to click the Select hyperlink for Florida Web Portal listed on the left hand side and then they will need to select Download 835 listed on the right hand side (see screen shot below).  Once those steps are completed, click Save Changes. 

After these 3 steps have been completed, all future ERAs will be delivered to MedAvant and we will send them directly to the provider just as they were before the migration to EDS. 

For any ERAs for the provider that were created before these 3 steps have been completed, they have been delivered to this payer portal under the provider’s account.  To access those outstanding ERAs, the provider will need to complete the 3 steps listed above and then access the payer portal again, but instead of clicking on Account Management (as was shown in Step 1), they will click on Florida Web Portal.  On the next screen that comes up, they will click on Trade Files (see screen shot below).

Next, the provider will need to click on download listed on the left hand side of the screen.  Once clicked, the provider will then select the Document Type of 835_X12_BATCH (see screen shot below) and then click Search listed on the right hand side.  Any ERAs that have been generated since the transition to EDS will then be listed for the provider to download.

Submitter Actions:  Follow above instructions to authorize the release of your ERA’s to MedAvant

Notification ID: 20080724-01

REMINDER MedAvant and Medi-Cal NPI(MC051)

Tuesday, Jul 22, 2008 - 05:00:25 PM

Important Message from MedAvant

Date Range: Effective May 22, 2008 – Forward

Details:

Medi-Cal NPI Enrollment and Registration Edits

Effective May 22, 2008 MedAvant will enforce NPI Enrollment validation edits for Medi-Cal claim submissions.
What you need to know:
  •  If you have not registered and linked your NPI to MedAvant’s submitter ID (FVJ), your claims will reject at MedAvant with the following rejection message:

"PROVIDER IDENTIFIER IS MISSING, INVALID, OR NOT AUTHORIZED FOR THIS PAYER."

Solo Practices
Each solo practice/provider must have registered their NPI with Medi-Cal.  If you are filing claims as a solo provider, the pay-to-provider NPI must be registered and linked to MedAvant. If filing claims as a solo provider and filing with s group or billing NPI, the group NPI must be registered and linked to MedAvant as the submitter (FVJ).
**Provider registration with Medi-Cal is specific as to whether billing as an individual or group provider**

Group Practices
Group practices must register their NPI with Medi-Cal and must be linked to MedAvant as the submitter (FVJ). Providers within the group must also register their NPI with Medi-Cal.

2010AA (Billing Provider) - NPI must be registered with Medi-Cal and linked to MedAvant as the submitter (submitter ID = FVJ).
2310B (Rendering Provider)  - The NPI # listed in this loop must be registered with Medi-Cal

AGREEMENTS:
Medi-Cal agreements can be accessed on MedAvant’s webpage:
http://www.medavanthealth.com/payerlist/agreements/MC051.D032608.pdf

MedAvant Submitter ID = FVJ

Submitter Actions: Register and Link your NPI with Medi-Cal / MedAvant

Notification ID: 20080721_02

Anthem Blue Cross of California (BC001) ERA Delivery Issue

Tuesday, Jul 22, 2008 - 04:52:14 PM

Important Message from MedAvant

Date Range: 7/14/2008 – 07/16/2008

Details:

ERA’s that were issued during the migration to the Anthem Enterprise Gateway on 07/15/2008 were not delivered to Medavant electronically. Anthem is unable to post these ERA’s electronically and is requesting for providers with missing ERA’s during this date range to request paper ERA’s directly from them.

Submitter Actions:  Contact Anthem Blue Cross to have missing ERA’s posted on paper

Notification ID: 20080722-01

Florida Medicaid (MC010) Migration Update

Thursday, Jun 19, 2008 - 01:49:29 PM

Important Message from MedAvant

Date Range:  Effective June 19, 2008

Details:

Florida Medicaid claims will be migrating to a new EDI vendor effective Monday, June 23, 2008.
Their system is shut down as of today, June 19, 2008 until Monday morning.
All claims submitted during this time will be held and sent to Florida Medicaid on Monday, June 23, 2008.

Submitter Actions: No action required

Notification ID: 20080619-01