CIGNA Government Services (CGS) was awarded the Part A/Part B Medicare Administrative Contractor (A/B MAC) for Jurisdiction 15, which includes the Ohio Part B workload, scheduled to transition to CGS on June 18, 2011. CGS is committed to facilitating a seamless transition with no disruption of claims processing for existing Electronic Data Interchange (EDI) submitters.
CGS will utilize a process called early boarding which allows a provider to submit claims to CGS prior to the cutover to avoid tight timeframes for transitioning during cutover weekend. Early boarding helps to mitigate any disruption in EDI services during the J15 Ohio Part B workload transition. During early boarding, Palmetto GBA will continue to process your Medicare claims will continue to be processed by Palmetto GBA. As a provider, you will submit your EDI transactions to CGS. As the A/B MAC, CGS will translate these EDI transactions and return your TA1 or 997. We will forward syntactically correct claims to Palmetto GBA for processing. If you are currently receiving electronic remittance notices (835s) with Palmetto GBA, you will be set up to continue to receive them during early boarding.
During early boarding, EDI submitters may establish a connection by selecting a direct dial up connection or a network service vendor. Note that the CGS asynchronous electronic network is referred to as "Stratus." CGS will support the billing software you currently use to submit claims to Palmetto GBA. CGS is waiving our requirement of having the software tested and approved. During the early boarding process, you will continue to submit your claims with the current contractor ID. However, you will be required to change the contractor ID at cutover on June 18, 2011. The new Contractor ID number for Ohio Part B customers is 15202, and should be used for all claims submitted to CGS following cutover on June 18, 2011.
Here are some additional key pieces of information to note:
•Current EDI submitters who have completed an EDI enrollment form with Palmetto GBA do not need to re-enroll. The existing EDI enrollment forms will be transferred to CGS at cutover on June 18, 2011.
•A new submitter ID is not required. You will continue to use the same submitter ID assigned to you by Palmetto GBA.
•There will be no 5010 testing or transition activities from April 1, 2011 through the cutover on June 18, 2011.
•CGS is subcontracting with Palmetto GBA to provide 5010 EDI translation services for Ohio Part B claims starting at cutover on June 18, 2011 and continuing through September 30, 2011. CGS expects to start 5010 translation during the month of September. During this time period, Palmetto GBA will be supporting 5010 testing, translation, and CEM integration to include second level help desk support.
•CGS will assume all 4010 translation along with the primary help desk support Ohio Part B claims on the June 18, 2011 cutover.
•The new Contractor ID number for Ohio Part B customers is 15202, and should be used for all claims submitted to CGS following cutover on June 18, 2011.
•EDI online training and additional information is available from our J15 Website at: http://www.cignagovernmentservices.com/j15/edi.html.
You will receive an early boarding packet via mail in the mid-April timeframe. The information within this packet will include early boarding instructions, EDI profile, Stratus connectivity and submission instructions, and Stratus mailbox and password.
Source:
http://www.cignagovernmentservices.com/j15/news/cope14181b.html