EDI COB

EDI COB Center For Celerian Group Companies Customers, Beneficiaries And Providers EDI COB Center Assistance is given for CGS (Celerian Group Companies) contractors regarding EDI Coordination of Benefits issues. EDI COB Center Assistance (Benefits Coordination & Recovery Center) is provided to: All Customers Answers to general questions regarding Medicare Secondary Payer (MSP). Requests for duplicate questionnaires. Beneficiaries Read More →

ASC X12 Implementation

ASC X12 Implementation Acknowledgement (999) (CAQH CORE Certification) ASC X12 Implementation Acknowledgement (999) must be always returned by CORE-certified organizations. The organization must successfully complete all of the required certification test scripts required by the Phase II CAQH CORE Certification Test Suite to become CORE-certified. The ASC X12 Implementation Acknowledgement (999) can be used only to acknowledge Read More →

X12 Interchange Acknowledgement (250: Claim Status Infrastructure Rule) X12 Interchange Acknowledgement must be returned for real time X12 276 claim status inquiries if the functional group is rejected, or the X12 277 response, to be conformant with this rule. CAQH CORE Rules do not address usage of the X12 Interchange Acknowledgement TA1.  To send real time acknowledgments Read More →

HIPAA CAQH CORE Batch Processing (250: Claim Status Infrastructure Rule) HIPAA CAQH CORE recognizes that every organization has its own record-retention policies and, therefore, does not mandate a strict requirement for retention of response files. However, CAQH CORE recommends that a copy of responses be kept available for a minimum of six months after they Read More →

HIPAA CAQH CORE

CAQH CORE HTTP/S (250: Claim Status Infrastructure Rule) Connectivity CAQH CORE HTTP/S is secure and reliable enough to protect the delivery of healthcare information over the Internet. In Phase I development discussions, CAQH CORE solicited input on this topic from its Technical Work Group members and experts within healthcare and other industries, such as financial services. Based on Read More →

CAQH CORE 250

CAQH CORE 250: Claim Status Infrastructure Rule Guides CAQH CORE 250 Rule for operating rules for the eligibility and claim status transactions adopts all the Phase I and II CAQH CORE Eligibility and Claim Status Operating Rules except those requirements pertaining to the use of Acknowledgements. Entities seeking CORE Certification must implement all of the CAQH CORE Eligibility and Claim Read More →

CGS EDI Enrollment

CGS EDI Enrollment Provider Guidelines CGS EDI Enrollment form (commonly referred to as the EDI Agreement) should be submitted when enrolling for electronic billing. It should be reviewed and signed only by the providers to ensure each provider is knowledgeable of the enrollment request and the associated requirements. Providers that have contracted with a third Read More →

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CGS EDI Program: Advantages and myCGS Portal CGS EDI Program offers advantages to providers who conduct business with Medicare electronically. Some of those benefits include: No more paper claims: EDI (submitting claims to CGS electronically eliminates paperwork so your staff can accomplish more in less time. You will also save money on postage and claim forms. Earlier payment Read More →

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Rejected HIPAA Claims Basic Guides (CGS Administrators, LLC) Rejected HIPAA Claims are claims that are in a rejected status and has failed one of the set validations. Find below some ANSI Claim Rejections. More ANSI Claim Rejections examples can be found in the previous posts. X222.262. 2310B. NM109.030 This Claim is rejected for Invalid Information for a Rendering Provider’s National Read More →

Top 10 ANSI Claim Rejections

Top 10 ANSI Claim Rejections Examples Top 10 ANSI Claim Rejections occur at multiple locations within the electronic EDI claim. Suppliers are strongly encouraged to review all aspects of a claim denial. Find below Top 10 ANSI Claim Rejections. X222.087. 2010AA. NM109.050 This Claim is rejected for relational field due to Billing Provider’s submitter not approved for electronic claim Read More →