I wanted to thank everyone that has sent me new prefixes to add to my list. Please keep them coming. I did some digging and the Wellpoint plans have published the new prefixes for the health exchange plans. I added those yesterday along with a few more I’ve found. I still have another handful that I’ll add in a few days.
As I’m adding them, I’m changing the format of the tables to make them a little easier to deal with. Please note that the new tables can only display up to 100 lines at a time. If you don’t see the prefix you’re looking for, you may need to go to the next page.
Over the next few weeks you’ll notice format changes on the prefix pages. The way the tables are loaded currently, adding additional prefixes is somewhat of a nightmare. I’m going to be converting those pages into a different style of table so they’ll be easier to update. Also I’m looking for someone to help me update them monthly so you’ll see more frequent changes/additions.
If there are prefixes you would like to have added, please send them through Contact Us (it’s in the footer).
A few interesting tid bits this week.
CMS will be making some changes to the Medicare realtime eligibility response next weekend. This does not effect DDE responses (HIQA, HIQH,etc).
1. The Medicare preventive data will be removed from the response. It will only be returned if a HCPCS code is specifically requested. So if you’re trying to find out if the beneficiary is eligible for a mammogram, you will need to request one of the mammography HCPCS codes. They will also be showing more detailed financial info on each service including whether or not the deductible and/or coinsurance is waived for that service. I’ve include the screening tests below with the appropriate codes.
2. The response will now show the individual hospice periods instead of lumping them into one large period. You will be able to see the beginning and ending date for each period.
North Carolina Medicaid will be switching to their new claims system, NCtracks, effective 7/1. There’s a pretty lengthy checklist of things that need to be completed by the conversion, which I have included below along with the registration application. I’m going to assume most of you have already done this so this really only applies to the procrastinators.
There are rumors floating around that the new fiscal agent, CSC, won’t be ready to provide realtime eligibility come 7/1. Also in order to get eligibility through your current vendor, you will need to log into the NC Tracks web portal and designate your vendors. You will have to do this for both your claims clearinghouse and your eligibility vendor. Unfortunately you can only choose one vendor until July. For more information, there is a special website setup for NCTracks or you can sign up for their email list.
The purpose of this checklist is to help DHHS providers understand the tasks they need to perform, and how and when to do them, to enable a smooth transition to the new NCTracks system.