DME
MAC Jurisdiction C Site LinksApril 28, 2008
Attention All DME MAC Electronic Submitters and Vendors
URGENT REMINDER: Electronic Trading Partners in Jurisdictions A and D must be transitioned to CEDI before May 1, 2008.
Electronic Trading Partners in Jurisdictions B and C must be transitioned to CEDI before June 1, 2008.
All trading partners/submitters can transition to CEDI prior to the cutover date for the Jurisdiction(s) with which they currently exchange electronic transactions.
This listserv contains important information as to how to submit claims before the scheduled cutovers and other information regarding CEDI and your transition. Please be sure to read the entire listserv message.
To become a CEDI production submitter you must:
- Make sure your software vendor has completed testing with CEDI. A list of approved CEDI vendors can be found by clicking on the following link: http://www.ngscedi.com/outreach_materials/Approved_CEDI_Vendor.pdf
- Obtain the necessary software and/or communications changes from your vendor to interact with the CEDI system.
- Contact your vendor to CEDI as soon as possible to prevent any disruption in exchanging your DME electronic transactions.
All trading partners/submitters can transition to CEDI prior to the cutover date for the Jurisdiction(s) with which they currently exchange electronic transactions.
CEDI is receiving all Front End Edit Reports and electronic remittance advice (ERA) files produced by the DME MAC Jurisdictions regardless of whether the claims were submitted to a DME MAC or to CEDI. This allows a trading partner/submitter to submit claims to a DME MAC on one day and to move to CEDI the next day with the ability to receive all Front End Edit Reports and ERAs. CEDI maintains 45 days of reports and ERAs under each CEDI login for retrieval by the trading partners/submitters.
Jurisdiction A EDI Front End and Help Desk Support
On April 30, 2008, the Jurisdiction A EDI front end will be taken down at 5:00 p.m. (ET) to remove the ability for trading partners/submitters to send claims and download front end edit reports and/or electronic remittance files.
CEDI is receiving all Front End Edit Reports and electronic remittance advice (ERA) files produced by the DME MAC Jurisdictions regardless of whether the claims were submitted to a DME MAC or to CEDI. After April 30, 2008, Jurisdiction A trading partners/submitters will need to retrieve their ERA and front end reports from CEDI. CEDI maintains 45 days of reports and ERAs under each CEDI login for retrieval by the trading partners/submitters.
On April 30, 2008 the Jurisdiction A Help Desk will no longer be available to assist trading partners/submitters with EDI related questions or issues. The Jurisdiction A Help Desk will only provide support as listed in the section below, "DME MAC Support".
Questions regarding CEDI should be referred to the CEDI Help Desk via email at NGS.CEDIHelpdesk@wellpoint.com and by telephone at 866-311-9184. The CEDI Help Desk is available from 9:00 a.m. – 9:00 p.m. (ET) Monday through Friday.
Jurisdiction D EDI Front End and Help Desk Support
On April 30, 2008, the Jurisdiction D EDI front end will be taken down at 5:00 p.m. (ET) / 4:00 p.m. (CT) to remove the ability for trading partners/submitters to send claims. The Jurisdiction D front end will allow trading partners/submitters to download outstanding front end edit reports and/or electronic remittance files generated by Jurisdiction D. Please note there will be no EDI support for the Jurisdiction D front end.
CEDI is receiving all Front End Edit Reports and electronic remittance advice (ERA) files produced by the DME MAC Jurisdictions regardless of whether the claims were submitted to a DME MAC or to CEDI. After April 30, 2008, Jurisdiction D trading partners/submitters should retrieve their front end reports and/or electronic remittance files from CEDI. CEDI maintains 45 days of reports and ERAs under each CEDI login for retrieval by the trading partners/submitters.
On April 30, 2008, at 6:00 p.m. (ET) / 5:00 p.m. (CT) the Jurisdiction D EDI Help Desk will no longer be available.
Questions regarding CEDI should be referred to the CEDI Help Desk via email at NGS.CEDIHelpdesk@wellpoint.com and by telephone at 866-311-9184. The CEDI Help Desk is available from 9:00 a.m. – 9:00 p.m. (ET) Monday through Friday.
DME MAC Support
The DME MAC Jurisdictions will continue to provide support for the following services after EDI functions have transitioned to CEDI.
- Claim Status Inquiry (CSI), VPIQ and/or PINQ
- Enrollment or setup status
- Logon or User ID
- Password resets
- Education
- Electronic Funds Transfer (EFT)
- Setup Status
- Questions regarding payments or banking information
- Status of claims in the Jurisdiction A, B, C and/or D DME MAC processing system
- Questions regarding the adjudication of claims
- Questions regarding the content of an Electronic
Remittance Advice
- Amount paid on a claim
- Deductible or co-pays applied
- Denied claims
DME MAC Contact Information
Visit the DME MAC Jurisdictions' Web sites listed below to obtain the appropriate contact telephone numbers.
- Jurisdiction A DME MAC: NHIC, Corp.
- Jurisdiction B DME MAC: National Government Services, Inc.
- Jurisdiction C DME MAC: CIGNA Government Services
- Jurisdiction D DME MAC: Noridian Administrative Services
PC-Ace Pro32 Software Users
All PC-Ace Pro32 users must complete the following instructions to communicate with CEDI.
- Visit the CEDI Web site at www.ngscedi.com. Select "Telecommunications" and download the Asynchronous Communication Manual.
- Contact the CEDI Help Desk at NGS.CEDIHelpdesk@wellpoint.com to obtain the CEDI phone number and your password. Be sure to provide your Trading Partner/Submitter ID and your company name.
- Follow the instructions in the Asynchronous Communication Manual to change the dial-in phone number to the CEDI phone number obtained from the CEDI Help Desk.
- Follow the instructions in the Asynchronous Communication Manual to dial, login, connect and begin sending and receiving files with CEDI.
- The January 2008 version of PC-Ace Pro32 is the most current version. There was not an upgrade release for April 2008. CEDI will provide the July 2008 upgrade on the CEDI Web site.
Express Plus Software Users
All Express Plus users must download the upgrade (Version 4.3.8) and follow the instructions below to communicate with CEDI. To download and begin using the new Version 4.3.8 of Express Plus, you need to:
- Access the CEDI Web site at: http://www.ngscedi.com
- Select "Software Downloads"
- On the "Software Downloads" page, print ALL of the following
documents:
- Express Plus Upgrade Instructions - These instructions will guide you through the process of running the Express Plus upgrade program.
- Express Plus CEDI Script - These instructions will guide you through the procedures to create the communications' scripts to connect to and send/receive files with CEDI.
- Express Plus CEDI Connection and Login - These instructions will assist you in logging into CEDI and sending/receiving files with CEDI.
- Follow the instruction documents listed in the order above.
- You may also download the updated DME Express Plus User Manual from the "Software Downloads" page.
CEDI Claims Submission Cutoff Times
CEDI will accept claims submissions 24 hours a day, Monday through Sunday (See the CEDI Maintenance Window section below).
CEDI delivers claims and 276 Claim Status Request files to the DME MACs at 4:00 p.m. (ET) Monday through Friday. Files received before 3:00 p.m. (ET) will be delivered that day to the DME MACs for processing and you will receive your DME MAC Front End Edit Report and/or 277 Claim Status Response file the following business day.
Claims and 276 Claim Status Request files received between 3:00 p.m. and 3:30 p.m. (ET) may be delivered on the next business day and you will receive your DME MAC Front End Edit Report two business days following submission of your claim file.
Claims and 276 Claim Status Request files received after 4:00 p.m. (ET) will be delivered on the next business day and you will receive your DME MAC Front End Edit Report and/or 277 Claim Status Response file two business days following submission of your file.
CEDI Maintenance Window
CEDI performs routine maintenance on Sundays between 12:00 a.m. - 12:00 p.m. (ET). During this time, CEDI will accept electronic files but will not produce Level 1 and GenResponse reports. Beginning no later than Monday at 12:00 a.m. (ET), CEDI will resume processing files received on Sundays and will begin to return Level 1 and Gen Response reports.
CEDI Listserv
To stay informed of all CEDI updates, visit the CEDI Web site at www.ngscedi.com and sign up for the CEDI Listserv by selecting the Listserv Registration Link. You will then be prompted to submit your email address and name to subscribe. This listserv is for all entities participating with CEDI whether you are a third-party billing agency or a supplier performing your own EDI transmissions.
