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EDISS Historic Reports and Remits

(02/05/2014)

From: EDISS Email Distribution [mailto:hipaalist@noridian.com]
Sent: Wednesday, February 05, 2014 6:01 AM
To: Hipaa Submitter
Subject: [hipaasubmitter] EDISS Email Distribution -- February 5, 2014 -- Scheduled Education

Historic Reports and Remits

For All Submitters

As of January 6, 2014, the EDISS Submitter mailbox has a 30-day retrieval timeframe for reports and remits. After 30 days, they are archived and no longer available. To ensure Submitters are receiving and retaining all items, they should:

·   Log into their mailbox weekly.

·   Verify the download destination of your reports and remits.

o  If retrieving data via a direct connection, this will ensure these files are continually available.

o  If working with a vendor on claim submissions or remittance advice, work with your vendor to determine process.

·   Contact vendor to discuss process of saving critical files.

·   Backup all EDISS mailbox data received.

For additional information related to the Historic Report/Remittance Policy, visit http://www.edissweb.com/. Select your state and select Historic Report/Remittance Policy under the Quick Links.

What is ASCA?

For All Medicare Part B Submitters

The Administrative Simplification Compliance Act (ASCA) prohibits payment of initial health care claims not sent electronically as of October 16, 2003, unless you meet one of the exception criteria. EDISS sends letters out to providers that have sent paper claims to Medicare, requesting that they either send claims electronically or send a request to be exempt from sending claims electronically. If a provider is approved, they will be requested, via letter, every two years to send supporting documentation to renew their approval.

The most common exception criteria that EDISS processes and approves are as follows as well as examples of what is needed to support the request:

·    Small provider – fewer than 10 full-time equivalent employees

o  A full quarter’s worth of payroll records, indicating hours worked by each employee.

o  Tax form that indicates the number of employees.

o  Tax form that indicates the wages paid for those providers who don’t have employees.

·    Providers that submit less than 10 claims per month on average or less than 120 claims during the previous year

o If this option is selected, EDISS bases the approval on what Medicare has on file for claims.

·    Mass Immunizers

o Must be set up with Medicare as a Mass Immunizer only.

·    Dentists

o Copy of Dental License.

Visit http://www.edissweb.com/cgp/registration/asca.html for additional information related to ASCA.

Endeavor Assistance

All Medicare Submitters

EDISS has experienced an increase in misdirected calls relating to Endeavor and would like to provide Endeavor users with a few helpful tips to point you in the right direction. 

·    Endeavor Enrollment - Providers can enroll for Endeavor access or update current access by registering at https://www.noridianmedicare.com/.  Endeavor allows providers to check eligibility, claim status, appeal status, redetermination submission and access full remittance advice online.  Your request will take approximately 7-10 business days to process. 

·    Endeavor Password Assistance and Login Issues - Password resets and login assistance are completed by User Security. When you call the IVR, you will state “No” to the first question and “User Security” to the second question.

·    Endeavor Navigation Questions – Navigation questions can be answered by contacting the Provider Call Center or going to  https://www.noridianmedicare.com/.  Searching for “Endeavor User Manual” will provide the most comprehensive resource to understand the provider portal.

·    Endeavor Alerts/Notices – Alerts and Notices in regards to Endeavor availability, downtime or other incidents are updated at www.noridianmedicare.com. Under Medicare Part A or Medicare Part B, select Jurisdiction E or F to view the alerts and notices applicable to your line of business.

Electronic Data Interchange Support Services (EDISS) is the EDI solution for various healthcare payers. EDISS exchanges electronic data for both Medicare and commercial business.

This distribution is sent to subscribers wishing to receive the latest Electronic Data Interchange (EDI) updates. Direct all questions regarding the content of this Email to EDISS. Do not reply to this Email.

Some of the provider information contained on the EDISS email distribution is copyrighted by the American Medical Association and the American Dental Association. This includes items such as CPT codes and CDT codes. Information contained within this distribution is not intended to be republished or shared with Trading Partners who are not customers of EDI Support Services. Any unauthorized use, disclosure, distribution or copying is prohibited. Due to different email settings, attachments may appear with this email. Please ignore any attachments that are included with this email. EDISS uses Total OnBoarding to gather the most current email contact listing of our Trading Partner community. If you wish to unsubscribe from EDI Support Services’ Email Distribution, click here.

Confidentiality Notice: This communication and any attachments are for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure, distribution or copying is prohibited. If you are not the intended recipient(s), please contact the sender by replying to this e-mail and destroy/delete all copies of this e-mail message.

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