May 30, 2000

Medi-785-00

TO: ALL MEDICARE PROVIDERS

SUBJECT: SCHEDULE DATES- ADDITIONAL UPDATE

PRIMARY INTEREST: BUSINESS OFFICE MANAGERS

The Health Care Financing Administration has announced another revised implementation and/or effective date for the following items due to the complexities involved in making the related system changes necessary for implementation.

The following items will be implemented by all Medicare contractors on June 5, 2000. The effective date of the provision will remain as originally communicated to the providers. In the event the contractor implementation date is delayed beyond June 5, we will issue a notification.

All Medicare contractors will implement the following items on June 5, 2000. The effective date of the provision is being revised from the date originally communicated to the providers. In the event the contractor implementation date is delayed beyond June 5, we will issue a notification.

The Common Working File (i.e. HIQA), Direct Data Entry (DDE) into the Fiscal Intermediary Shared System (FISS) and RGBA’s Automated Response Unit (ARU) will not be available to providers on Friday, June 2 and Saturday June 3, 2000.

June 5, 2000 Providers must report line-item dates of service for every line where a HCPCS code (including modifiers) is required for hospital outpatient, community mental health center (CMHC), and outpatient partial hospitalization services. This includes services for which the from and through dates are equal.

Providers must report units as the number of times the service or procedure being reported was performed.

Hospitals can bill up to 297 revenue lines per claim via EMC or DDE.

July 1, 2000 EMC version 6.0 of the UB-92 will be available for all users. This version expands the number of revenue input lines to 450 as well as the number of COB crossover revenue lines.

Hospitals can now bill up to 450 lines via DDE as needed.

E. System Outputs June 5, 2000

The paper remittance advice (RA) will continue to display claim level information only.

An upgraded release of PC-Print (remittance advice software) is available which has an increased file size in order to display up to 450 revenue lines. There are two versions being supported. The latest version will print ERA versions 3051.4A and 3051.3A. The prior version works with the 3030M version. Providers using PC-Print will be able to see the same information as before, based on the version of the ERA in use. If line item-level information was provided on the ERA, then the line item-level information will also be printed by PC-Print. There are file limitations, however. PC-Print is designed primarily for use by smaller providers, and cannot accommodate more than 30,000 X12 segments.

FISS providers submitting claims using EMC version 5.0 with line item details will receive full line item payment data in their ERA if they have elected to receive ERA version 3051.4A.

Providers will see no change to ERA versions 3030M (2.A) or the 3051.3A.

DDE providers will be able to see the reimbursement, coinsurance, deductible, MSP, and non-covered monies by line, but will not have the specific non-covered reason displayed for that line item.

July 1, 2000 Transitional Payments (TOPs) and outlier payments associated with Outpatient

PPS, where applicable, will be reported at the provider level in all ERA versions for all users. TOPs will also be reported at the provider level in the paper RA.

THIS BULLETIN SHOULD BE SHARED WITH ALL HEALTH CARE PRACTITIONERS AND MANAGERIAL MEMBERS OF THE PROVIDER STAFF. NO COST COPIES ARE ALSO AVAILABLE FROM OUR WEB SITE AT riverbendgba.com

Please refer any questions to our office at (423) 755-5950.