Companion Guide Trading Partner Information

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1 Companion Guide Trading Partner Information ASC X12 Standards for Electronic Data Interchange Technical Report Type 3 (TR3) v.5010

2 Table of Contents Preface Getting Started Where to Get Information Enrollment Existing Electronic Submitters New Electronic Submitters Trading Partner Agreement Electronic Remittance Advice (835) Electronic Submitter IDs and Passwords Connectivity / Communications Communication Methods Asynchronous Communications FTP Communications Moveit / Data Mover AHIN Transactions Testing Criteria and Requirements Reports Contact Information...11 Page 1

3 Preface The information in this companion guide is to provide guidance to trading partners who will be exchanging electronic data with Arkansas Blue Cross Blue Shield and its subsidiaries. This document is intended to clarify information for submission of specific electronic transactions. This includes information about enrollment, connectivity, testing and support. The Companion Guide will provide trading partners supplemental information and further define specific data content requirements to be used in conjunction with, and not in place of, the ASC X12N TR3s for transactions mandated by HIPAA for electronic data interchange. An electronic data interchange trading partner is defined as any customer that transmits or receives electronic data to or from Arkansas Blue Cross Blue Shield and its subsidiaries. The Arkansas Blue Cross Blue Shield family of companies includes: Arkansas Blue Cross Blue Shield Blue Advantage Administrators Health Advantage FEP Access Only Medipak Medipak Advantage ITS A customer is defined as a provider, billing service, clearinghouse or software vendor. The Arkansas Blue Cross Blue Shield Companion Guide has been created to assist you in designing and implementing transactions for version 5010 to meet line of business specific processing standards. This document will be updated periodically as deemed necessary. Additional information and updates can be found on the Arkansas Blue Cross Shield website under the 5010 Resource Center. It is highly recommended and encouraged that you visit the 5010 Resource Center frequently for updates. The 5010 Resource Center can be accessed at Page 2

4 1. Getting Started 1.1 Where to Get Information Arkansas Blue Cross Blue Shield and its subsidiaries are committed in providing customer service support to our trading partners. In an effort to assist trading partners with the implementation of version 5010 and their data exchange needs, several methods of communication are available. A 5010 Resource Center has been developed and added to the Arkansas Blue Cross Blue Shield website. The 5010 Resource Center will provide trading partners information about the implementation of version 5010, timelines and other valuable information. The 5010 Resource Center can be accessed by clicking on the link below. The EDI Services help desk is available to assist trading partners with the implementation of version EDI Services can be reached Monday through Friday from 7:00 am to 4:30 pm CST at (501) EDI Services can provide information about version 5010; assist trading partners with enrollment and connectivity. Another method of communication is the EDI mailbox. Electronic submitters can submit their questions to Trading partners can submit their enrollment questions, paperwork, changes to their current enrollment setup or submitter update information to Additional information and enrollment forms can be found at If needed, trading partners can call EDI Services for assistance at (501) Information pertaining to the implementation of version 5010 will be published in provider newsletters. Provider newsletters are published quarterly and are available on the Arkansas Blue Cross Blue Shield website at Page 3

5 1.2 Enrollment Existing Electronic Submitters Trading partners who are currently enrolled with EDI Services and have been issued a submitter ID number and password will not be required to re-enroll to transition to version Your current electronic submitter ID number and password will be used to transmit and receive electronic transactions for version New Electronic Submitters Trading Partner Agreement New providers, billing agents, clearinghouses and software vendors who have never exchanged electronic data with Arkansas Blue Cross Blue Shield must enroll with EDI Services. The ARKANSAS BLUE CROSS BLUE SHIELD ELECTRONIC DATA INTERCHANGE TRADING PARTNER AGREEMENT form must be completed. The form can be downloaded from the Arkansas Blue Cross Blue Shield website at Completed forms can be submitted to EDI Services by US mail, FedEx or UPS, faxed or . Listed below is additional information for each method of delivery. Delivery through US mail: Delivery through FedEx or UPS: EDI Services 4BC/S EDI Services 4BC/S P. O. Box S. Gaines St. Little Rock, AR Little Rock, AR Fax to: (501) to: Attn: EDI Enrollment If you have questions or need assistance completing the enrollment paperwork, please contact EDI Services at (501) or EDI Services at Electronic Remittance Advice (835) If you are enrolling with EDI Services and want to receive electronic remittance advices you must complete the ABCBS Electronic Remittance Advice Request Form (ERA/835). The ERA form can be downloaded from the Arkansas Blue Cross Blue Shield website at Completed forms can be submitted to EDI Services using the same delivery methods as the Trading Partner Agreement. Page 4

6 Electronic Submitter IDs and Passwords An electronic submitter ID number and a initial password will be assigned to you upon completion of the ARKANSAS BLUE CROSS BLUE SHIELD ELECTRONIC DATA INTERCHANGE TRADING PARTNER AGREEMENT and / or the ABCBS Electronic Remittance Advice Request Form (ERA/835). INITIAL PASSWORDS MUST BE CHANGED UPON THE FIRST LOGIN ATTEMPT. PROVIDERS ARE NOT PERMITTED TO SHARE THEIR PERSONAL EDI SUBMITTER ID NUMBER AND PASSWORD WITH: ANY BILLING AGENT CLEARINGHOUSE / NETWORK SERVICE VENDOR ANYONE ON THEIR OWN STAFF WHO DOES NOT NEED TO SEE THE DATA FOR COMPLETION OF A VALID ELECTRONIC CLAIM, TO PROCESS A REMITTANCE ADVICE FOR A CLAIM, TO VERIFY BENEFICIARY ELIGIBILTY OR TO DETERMINE THE STATUS OF A CLAIM NO OTHER NON-STAFF INDIVIDUALS OTHER ENTITIES A PROVIDER S EDI SUBMITTER ID NUMBER AND PASSWORD SERVE AS A PROVIDER S ELECTRONIC SIGNATURE AND THE PROVIDER WOULD BE LIABLE IF ANY ENTITY WITH WHICH THE PROVIDER IMPROPERLY SHARED THE SUBMITTER ID NUMBER AND PASSWORD PERFORMED AN ILLEGAL ACTION WHILE USING THAT SUBMITTER ID NUMBER AND PASSWORD. A PROVIDER S EDI SUBMITTER ID NUMBER AND PASSWORD ARE NOT PART OF THE CAPITAL PROPERTY OF THE PROVIDER S OPERATION, AND MAY NOT BE GIVEN TO A NEW OWNER OF THE PROVIDER S OPERATION. A NEW OWNER MUST OBTAIN THEIR OWN EDI SUBMITTER ID NUMBER AND PASSWORD. PROVIDERS THAT CONTACT A CONTRACTOR TO SUBMIT AND/OR RECEIVE TRANSACTIONS ELECTRONICALLY USING A BILLING AGENT AND/OR CLEARINGHOUSE/NETWORK SERVICE VENDOR, ARE REQUIRED TO HAVE AN AGREEMENT SIGNED BY THAT THIRD PARTY IN WHICH THE THIRD PARTY HAS AGREED TO MEET THE SAME MEDICARE SECURITY AND PRIVACY REQUIREMENTS THAT APPLY TO THE PROVIDER IN REGARD TO VIEWING OR USE OF MEDICARE BENEFICIARY DATA. CLEARINGHOUSE AND THIRD PARTY REPRESENTATIVES MUST OBTAIN AND USE THEIR OWN UNIQUE EDI SUBMITTER ID NUMBER, USER ID, AND PASSWORD FROM MEDICARE CONTRACTORS TO WHOM THEY WILL SEND OR FROM WHOM THEY WILL RECEIVE EDI TRANSACTIONS. All requestors must attest and acknowledge the Arkansas Blue Cross Blue Shield security statement: Requirements prohibit ABCBS data or ABCBS system access to entities or individuals outside the United States and its Territories. Providers, Submitters, Payers, Network Service Vendors, or anyone else who conduct ABCBS billing, access to ABCBS data or systems, cannot do so outside the United States and its territories unless explicitly authorized in writing by ABCBS or his/her designated representatives with concurrence from ABCBS personnel security department. Page 5

7 2. Connectivity / Communications 2.1 Communication Methods EDI Services has several communication protocols that electronic submitters can utilize to send and receive electronic transactions. Electronic submitters will need to determine which communication protocol they want to use. Call EDI Services at (501) if you have questions about the different communication protocols Asynchronous Communications Electronic submitters can exchange electronic data through the NetX Gateway by using an asynchronous (dialup) communication. An internal or external modem is required and a telecommunication package such as Hyperterminal. It is recommended that electronic submitters use Windows XP. Windows XP comes with Hyperterminal already installed. Windows Vista and Windows version 7 do not come with a pre-installed telecommunications package. Hyperterminal or another telecommunication package will need to be purchased and installed on these versions of Windows. Hyperterminal can be purchased for Windows Vista and Windows version 7 from EDI Services will not support the telecommunication installation on Windows Vista or Windows version 7. EDI Services will support the setup and connectivity of Hyperterminal only forwindows XP FTP Communications EDI Services can accept electronic transactions via FTP. Electronic submitters can exchange electronic data via FTP using a command line or a third party program of your choice. EDI Services will provide support for connectivity. However, EDI Services will not provide support for any third party programs. Electronic submitters will be solely responsible for the setup and maintenance of their third party programs. Electronic submitters are not required to use a third party program. Electronic submitters can continue to transmit and receive electronic transactions via FTP using a command line. FTP users are required to connect to the NetX Gateway using a dial-up connection prior to exchanging electronic data. It is recommended that electronic submitters use Windows XP as their operating system and Hyperterminal as their telecommunication package Moveit / Data Mover The Moveit method is a form of communication to exchange data with EDI Services. It involves an IP SFTP enabled setup for file sharing using a server based application. This method of communication would be used by larger provider practices. Electronic submitters create a location for electronic files to be exchanged. Moveit will search the location for electronic files that need to be transmitted and send reports back to the location that you have created. Moveit will perform this function two times a day. Data Mover is a non-based server application method of communication for exchanging data with EDI Services. Data Mover users will use a browser with an HTTPS or FTPS to exchange electronic data. This method of communication would be used by smaller provider practices that do not have a server. Data Mover allows users to send and receive electronic transactions themselves. Page 6

8 2.1.4 AHIN Electronic submitters who prefer enter claims via direct data entry can do so by using AHIN. Additional information about AHIN can be found at Transactions Arkansas Blue Cross Blue Shield and its subsidiaries will exchange the following transactions. Trading Partners must test and pass the most current adopted errata or addenda version(s). Transaction Type Version Code 270 / 271 Health Care Eligibility Benefit Inquiry and Response X279A1 276 / 277 Health Care Claim Status Request and Response X Health Care Claim: Professional X222A1 837 Health Care Claim: Institutional X223A2 837 Health Care Claim: Dental(FEP only) X224A2 835 Health Care Claim Payment/Advice X221A1 999 Implementation Acknowledgment for Health Care Insurance X231A1 Trading partners who will be exchanging electronic transactions for version 5010 must purchase their TR3s from Due to copyright laws, Arkansas Blue Cross Blue Shield cannot provide trading partners with the TR3 s. In addition to aforementioned transactions, AHIN users will continue to receive the Batch Processing report. Page 7

9 4. Testing Criteria and Requirements Claims that are submitted for testing should be representative of the services that you intend to submit to Arkansas Blue Cross Blue Shield after you are approved for production. Additionally, a variety of procedures should be submitted for testing, as applicable to your specialty. YOU MUST SUBMIT 5010 TRANSACTIONS IN A CONTINUOUS STRING. IF YOU DO NOT SUBMIT A 5010 TRANSACTION IN A CONTINUOUS STRING, YOUR FILE WILL NOT BE PROCESSED. AN EDI ANALYST WILL CONTACT YOU ABOUT YOUR REJECTED FILE. All claim submitters must produce accurate electronic test claims before being allowed to submit claim transactions in production. All submitters must send a test file containing at least 25 claims, which are representative of their practice or services. The number of claims could be increased or decreased, on a case by case basis, to ensure adequate testing of any given submitter. Test claims are subject to standard syntax and IG semantic data edits; documentation will be provided when this process detects errors. Standard syntax testing validates the programming of the incoming file and includes file layout, record sequencing, balancing, alpha-numeric/numeric/date file conventions, field values, and relational edits. Test files must pass 100 percent of the standard syntax edits before production is approved. IG Semantic Data testing validates data required for claims processing, e.g., procedure/diagnosis codes, modifiers. A submitter must demonstrate, at a minimum, a 95 percent accuracy rate in data testing before production is approved where, in the judgment of Arkansas Blue Cross Blue Shield, the vendor/submitter will make the necessary correction(s) prior to submitting a production file. Test results will be provided to the submitter within three (3) business days; during HIPAA version transitions this time period may be extended, not to exceed ten (10) business days. Many claim submitters use the same software, or the same clearinghouse to submit their electronic claims to Arkansas Blue Cross Blue Shield. Arkansas Blue Cross Blue Shield will not require clearinghouses, billing agents, or software vendors to submit 5010 test files for all of your clients. Billing services and clearinghouses are not permitted to begin to submit or receive EDI transactions on behalf of a provider prior to submission of written authorization by the provider that the billing agent or clearinghouse has been authorized to handle those transactions on the provider s behalf. Page 8

10 5. Reports Electronic submitters who will be exchanging electronic data in a 5010 format will receive the following reports. TA1 999 Batch Processing Report Below is an example of a TA1 report: ISA*00* *00* *ZZ*00520 *ZZ*E9999 *110407*2007*{*00501* *0*P*:~ TA1* *110406*1324*A*000~ IEA*0* ~ Below is an example of a 999: ISA*00* *00* *ZZ*00520 *ZZ*E9999 *110407*2007*{*00501* *0*P*:~ GS*FA*00520*E9999* * *1*X*005010X231~ ST*999*6PF6FO9PC*005010X231~ AK1*HC*4*005010X222A1~ AK2*837*0001*005010X222A1~ IK5*A~ AK9*A*1*1*1~ SE*6*6PF6FO9PC~ GE*1*1~ IEA*1* ~ The Batch Processing report will be created and formatted as it is today with claims submitted in version 4010A1. Electronic submitters will be notified in advance if any changes are made to the Batch Processing report with the implementation of version Page 9

11 6. Contact Information If you need assistance or additional information you can contact EDI Services at (501) Other helpful resources are: Provider newsletters Resource Center EDI Services Enrollment EDI address Washington Publishing Co. Page 10

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