News for ODJFS Trading Partners
Last updated: May 8, 2008
Provider Payments: The provider payment for July 3 will be delayed until July 7. This will also delay the availability of the 835 by several days. If you have any questions about the delivery of the 835, please contact the EDI Support Unit: MMIS-EDI-SUPPORT@jfs.ohio.gov
All NPI Typical Providers who submit Professional (837P) EDI claims to ODJFS: To assure compliance with NPI, as of 3/15/2008 ODFJS will deny claims when the NPI and Medicaid legacy numbers in the pay-to-provider field on the 837P do not match the NPI and Medicaid legacy numbers in the ODJFS NPI crosswalk.
Attention Medicare Crossover Providers: On 3/1/2008, Medicare will no longer require the Medicare legacy number on claims if providers have successfully tested their NPI/ Medicare legacy match with Medicare. ODJFS, however, will continue to use the Medicare legacy number to crosswalk the Medicaid legacy number for the adjudication of crossover claims. To ensure that your claims are being processed when crossing over from Medicare beginning on and after 3/1/08, please continue to submit your Medicare legacy number that ODJFS matches to the appropriate NPI in the billing or pay-to field on electronic claims submissions to Medicare. Providing both numbers is required to ensure appropriate processing of crossover claims.
Announcement to Nursing Facilities (NF) or those who bill NF claims: This message concerns submitting nursing facility room and board claims with non-covered days reported on the claim. The claim-level CLM02 charge amount is a total of the line-level SV203 covered days amounts. For non-covered days, a zero is reported in the SV203 and the non-covered charges are reported in the SV207.
NPI News
Ohio Medicaid has extended its dual-identifier period until May 23, 2008. Effective immediately, providers are required to use both their seven-digit Medicaid legacy provider number and their NPI on all EDI claims. Providing both numbers on electronic claims will ensure that claims are processed appropriately.
To support successful NPI implementation, Ohio Medicaid is providing for a limited time claim-specific explanation of benefits (EOB) information regarding system edits of Medicaid provider and NPI numbers submitted in 837 EDI-format transactions. Providers may find such EOBs on posted remittance advice documents during the dual identifier period. Please click here for more information or visit Ohio Medicaid's NPI Information site.