Changes to Electronic Front-End Report Effective October 6, 2008

Effective October 6, 2008, the following changes will occur on the electronic front-end reports returned to trading partners from CEDI:

• Additional front-end edits will be added to the current CEDI GenResponse (GENRPT) report.
  Note: A CEDI Error Code Manual will be published soon. Once available, a CEDI Listserv announcement will be distributed.
• Claims accepted on the CEDI GenResponse Report will be delivered to the appropriate DME MAC.
• Claims delivered to the DME MAC will continue to edit against the DME MAC Level II edits as they do currently.
• Claims accepted on the DME MAC Level II reports will be assigned a claim control number (CCN) that will be attached to the claim as it enters the DME MAC for processing.
• Level II reports created by the DME MACs will continue to be delivered back to the trading partners through CEDI.
• Most, if not all, claims that reject will be returned on the GenResponse Report. It will be extremely important for trading partners to monitor the GenResponse Report for rejected claims in order to correct and resubmit the claims to CEDI.

Effective Mid-November 2008 the following changes will occur:

• All electronic front-end claim editing will be done through CEDI and all front end rejections will be returned on the CEDI GenResponse (GENRPT) Report.
• The additional GenResponse edits that were implemented on October 6, 2008 will replace the DME MAC Level II edits and trading partners will no longer receive Level II reports from the DME MACs.
• Claims accepted on the GenResponse Report will be assigned a claim control number (CCN) and these will be indicated on a report that will go back to the trading partner from CEDI. This CCN will be attached to the claim as it enters the appropriate DME MAC for processing.
• DME MACs will continue to produce the CMN Reject and this report will be returned to trading partners through CEDI.

CEDI is working closely with the DME MAC software vendors to provide information about the front-end report changes. Updates are currently being made to the report documentation available on the CEDI Web site (www.ngscedi.com). When the updated materials are available a Listserv will be distributed.

Post Date 09/10/08