General
- I did not receive the CMS-588 form that was sent out. How do I get another copy and where do I send it?
- Will this transition affect DMERC claims?
- I tried submitting my EDI test claims and received an error message. Who should I contact?
- How will we handle our Part B claims that require documentation, if medical records will not be accepted via fax?
- How do I go about obtaining claim status and eligibility online?
- I submitted an EDI test and received the MCS Edit Report with testing results, and the report contained NPI errors. Is there something wrong with my NPI?
- When will we receive our first payment from Highmark Medicare Services?
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The CMS-588 form was only sent to those providers who currently receive Electronic Funds Transfer (EFT) from TrailBlazer. If you do not currently receive EFT from TrailBlazer, you are not required to complete the CMS-588 form at transition. If you do currently receive EFT from TrailBlazer and did not receive your CMS-588 form, please remember to complete all fields on the first page of the form, and then fill in the contractor name Highmark Medicare Services in Section V at the top of page 2 of the form. Also, be sure the form is signed and dated by the provider or an authorized delegated official on file with Medicare. You can download the CMS-588 form at: http://www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf
Send CMS-588 form to:
Highmark Medicare Services
Provider Enrollment Services
1800 Center Street
P.O. Box 890157
Camp Hill, PA 17089-0157Date Posted: 07/01/2008
Will this transition affect DMERC claims?
No, Highmark Medicare Services does not process DME claims.
Date Posted: 07/01/2008
I tried submitting my EDI test claims and received an error message. Who should I contact?
Please contact our EDI Help Desk at 1-866-488-0546, Option 3.
Date Posted: 07/01/2008
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When submitting paper medical documentation associated to an electronic claim, the Claim
Supplemental Information segment (PWK) is reported on the electronic claim. When sending an
electronic claim that contains an attachment, follow these rules to submit the attachment for your
electronic claim:- Maintain the appropriate medical documentation on file for electronic (and paper) claims
- Complete the Cover Sheet for Submitting Medical Documentation for Electronic Claims form.
- Clearly write the Patient Name, Health Insurance Claim (HIC) Number, Date of Service, and your
Medicare Provider Identification Number (PIN) on the cover sheet. Only send documentation for
one patient per Cover Sheet. - At least seven (7) days prior to your electronic claim submission, mail the Cover Sheet and all pertinent
medical documentation to Highmark Medicare Services. All new mailing addresses will be
published at least two weeks prior to each workload implementation. - In the Claim Supplemental Information Segment (PWK)
- Select the appropriate Report Type Code for the medical documentation
- Use the “By Mail” option for the Report Transmission Code
- Enter AC for the Identification Code Qualifier
- Report the Attachment Control Number as the Identification Code
NOTE: Only send medical documentation when necessary for the adjudication of procedures/services
that are unusual or require such documentation on a pre-payment basis. Otherwise, do not submit documentation
unless it is requested during claim processing.Date Posted: 07/01/2008
How do I go about obtaining claim status and eligibility online?
Highmark Medicare Services offers an Interactive Voice Response System (IVR) that provides quick and easy access to Medicare related information, including a FAX-on-Demand option. allows you to receive a copy of summary information that includes your Month-to-Date (MTD) and Year-to-Date (YTD) claim and payment amounts, a list of pending claims, or a list of finalized claims for a specific date range. If you currently order copies of vouchers through the IVR, the finalized claims FAX option will offer similar information in a list format. A detailed explanation about how to use the Highmark Medicare Services IVR system including what information is available can be located on our website at:
Part A: http://www.highmarkmedicareservices.com/parta/selfservice/ivr.html
Part B: http://www.highmarkmedicareservices.com/partb/selfservice/ivr.htmlDate Posted: 07/01/2008
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The purpose of conducting an EDI test in preparation for transition is to ensure that you can successfully connect to the Highmark Medicare Services' EDI Telecommunications Platform, transmit an EDI claim file, retrieve the 997 Functional Acknowledgement, and retrieve the MCS Edit Report. It is also an opportunity to view the new MCS Edit Report and learn how to read and interpret it. This is a very key component of your EDI Transition to Highmark Medicare Services.
If NPI errors are detected during this testing time period, please check the format and reporting of the NPI. If the correct NPI was reported in the proper format, the NPI error(s) may be as a result of the fact that the most current NPI crosswalk file is not available to Highmark Medicare Services for editing purposes as part of this EDI testing process. If you are reporting the same NPI on your production EDI files sent to your existing Medicare Contractor and are not receiving an error, then you should not receive an NPI error once you begin sending production files to Highmark Medicare Services after cut
over.Date Posted: 07/01/2008
When will we receive our first payment from Highmark Medicare Services?
Highmark Medicare Services will generate their first claims processing cycle on Monday, July 14, 2008. This cycle will include EDI claims received by Highmark Medicare Services from 4:00 p.m. on Friday, July 11, 2008 through Monday, July 14, 2008 at 4:00 p.m. However, since this transition involves changes within the HIGLAS payment system, a HIGLAS payment cycle will not occur until Thursday, July 17, 2008. It is anticipated that providers may see their first payments from Highmark Medicare
Services generated out of the claims processing cycle expected to take place on Thursday, July 17, 2008.Date Posted: 07/01/2008