CMS 5010 Alert -Processing Issues

Processing Issues with New Part A Common Edit & Enhancement Module

Description of the Problem

National Government Services experienced processing issues with the new Part A Common Edit & Enhancement Module (CEM). 

What This Means to You

Providers/trading partners are experiencing a delay in return of the 277 Claims Acknowledgment Transaction for impacted claims.

Current Status of Problem

National Government Services began to experience throughput processing issues with the new 5010 Part A Common Edit Module (CEM) on December 5, 2011. This issue has resulted in a delay of claims processing through the CEM Module, which has led to delays in claims being received into the FISS system. Providers submitting 5010 electronic claims have continued to receive the 999 Functional Acknowledgement Reports (999) but there have been delays in  receiving the 5010 277 Claim Acknowledgement reports (277CA) that the CEM produces . Although the issue has not been resolved, NGS has made significant process in working through the impacted Receipt dates and working towards resolution of this issue.

As of today, Electronic File submissions with Receipt Dates from December 5, 2011-January 13, 2012 have been processed through the CEM and the 277CA reports have been created.  Please note that due to an EDI Gateway Outage which occurred on January 17, 2012, providers who have not picked up their earlier reports may not have access to these older reports at this time.  Please use the FISS DDE Claims Inquiry function or IVR to confirm claims are in the FISS system.

All 999 and 277CA reports generated after January 17, 2012 would be available to providers in their electronic mailboxes.

The oldest receipt date that is currently in the processing queue is January 17, 2012. If trading partners have received accepted 999 reports for any files submitted with Receipt Dates from January 17, 2012 –January 25, 2012, please do not resubmit these electronic files as this may lead to delays in processing your claims. Due to these processing throughput issues that NGS continues to experience, please remember that the 277CA may take up to 5 business days to be available. 

If a 277CA has not been received or claims are not found in the claims system for a file with a receipt date prior to January 13, 2012, please contact the EDI Help Desk via the Online Email Inquiry Form or by calling the EDI Help Desk at 873-273-4334

National Government Services, Inc.

Corporate Communications

Copyright © 2011 Home Care Software Solutions.  All rights reserved.