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X-Link EDI Version 7.0
* * EDI Required Update and Upgrade Notice * *
Thank you for your patronage and your understanding during this major industry change.
Now that the May 23, 2008 deadline has come and gone without incident, we look forward to showing you the new additions we have been developing for X-Link EDI.
But don't forget, there are still many changes being made at the payor level that will continue to have reprecussions on EDI Software for the next several years. Please continue to update your EDI software on a regular basis.
Also understand that this Version 7 of X-Link EDI will not be modified or changed in any way after X-Link EDI Version 8 is released. The changes in this industry are to significant and costly, and economically force us to only apply the necessary and prolific changes to the current version.
* * * New Features Now Available: * * *
Claim Status Requests and Responses
Electronic Remittance Advice 835 Report
Call 888 e-Claim-1 for More Information
* * * Effective Florida Medicaid Administrator Change * * July 1st 2008
The State of Florida is changing the Administrator for the Medicaid Program from ACS to EDS. This change is significant as EDS is Internet Based (yes - no modems !!!). First, your office will need Internet Service at the X-Link EDI computer.Second, your office will need to purchase the X-Link EDI EDS Medicaid Module, as the ACS X-Link EDI Module will no longer work. Call 888 e-Claim-1 for More Information
Version Notes:
7.0g
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ANSI Claim Status and Remittance Codes
All codes were updated to the 7/1/2008 codes as distributed by WPC-EDI (CMS).
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X-Link
Added ability to view and/or print a log of Carrier and ID Changes from Internet Update sessions.
Corrected Issue with Payor IDs not being updated for the Default Receiver.
Added the display of the Installation Date and Time or the Last Date the X-Link EDI product was updated by the Internet Updater.
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Upgrades from V6
Corrected issue with upgrading data from V6.
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Scheduler
Rewrote the Scheduler with one unified Scheduler module. This module simplifies additions for CSR and ERA, as well as other future features and new receivers. This change has been applied to:
First Coast Florida Medicare
Availity/Availity Governmental
Gateway EDI
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PreEdits - Gateway, ClaimLogic and CareVu
If a PIN is specified for the billing or rendering providers, and it is for a Medicare, Medicaid, BS, or Champus claim, we check that the Qualifier is correct for the claim type, eg, the Insurance Company Type is set correctly.
The Referring TaxID is not required and if specified is checked to be 9 numerics. The PreEdits that remove the TaxID for some carriers was not changed.
The Referring UPIN is not edited.
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TriCare - Gateway, Availity Govt and CareVu
The TriCare PreEdits are now setup correctly. This change required that the following Carrier Codes Change:
TRcare => TriCareN
TRcareNo => TriCareN
TRcareSo => TriCareS
TRcareWe => TriCareW
You will need to reassociate your TriCare Insurance Companies from your PMS with one of the above new Carrier codes.
Removes SSN from Patients and Insured Parties.
Allows Group Numbers.
Requires Legacy TriCare Number must be specified.
Requires Insurance company type must be TriCare (or use Champus - 1H)
All other commercial preedits are also performed on TriCare claims.
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Gateway EDI Payor List Changes
Meritain Health 64157 Added (Meritain Health/North America Admin)
Benefit Coordinators Corp 25145 Changed Code
Medicare of OK 04302 Changed Code (Oklahoma Medicare)
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EDS Florida Medicaid
Added the removal of Patient SSN in claims (typo allowed SSN to be sent).
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Availity and Availity Governmental
Uses new communications user interface for better control over the communications process by the end user. Contains progress bar and version information.
Cancel Button Has been Added to the communications server.
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First Coast Florida Medicare
Added function to change the password every 30 days. The next time a batch of claims is sent, the password will change. It will automaticly change again when you send claims or recieve reports from First Coast more than 30 days after the last time the password was changed. You must change your password every 60 days or First Coast will disable your account !!!
Cancel Button Has been Added to the communications server.
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Claim Status
Corrected Issue with associating CSR Acknowledgements with the corresponding Request.
Corrected User Message during the Send CSR task that referenced 'Claims' instead of 'CSR'.
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Internet Updater
Changed update notice for clarity.
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Version Notes:
7.0f
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New Receiver
EDS Florida Medicaid - Refer to the faxes on how to change from ACS Florida Medicaid to EDS Florida Medicaid. Uploading and Downloading of files by the EDI software is not available due to issues at EDS. These issues are beyond our control. Please follow the instructions already faxed to your practice to upload the appropriately formatted Medicaid Claims files to EDS. Note, the payor IDs and other items have changed for EDS. Files generated for ACS will not be successfully processed or paid by EDS.
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Florida Medicaid - EDS, Availity Gvt, GatewayEDI, CareVu, McKesson and Claim Logic
The Florida Medicaid listing in the carrier relations screen has changed to:
STATE OF FLORIDA MEDICAID
The name change is a new requirement by EDS whether sending direct or via a clearinghouse. The EDI Code remains unchanged as FLcaid. This change will not break any current setups. It is simply a name change that will happen behind the scenes. No user action required.
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Version Notes:
7.0e
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Claim Status Requests and Responses
This new feature has been added to the following receivers:
Florida Medicare - First Coast
Claim Logic
Availity and Availity Govt (Availity is currently only processing Blue Cross and Humana requests, but assures us they process for all payors who provide CSR. No date when it will be available for other payors).
For more information contact our sales or customer service departments. Requires Activation Key.
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ERA Report
This new feature has been added to First Coast Florida Medicare only.
The report replaces the mailed paper EOB.
For more information contact our sales or customer service departments. Requires Activation Key.
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EPSDT Medicaid Reporting
EPSDT reporting is now fully functional for the appropriate CPT codes. Place the required codes in the EPSDT Referral Items or EPSDT Referral Codes of your practice management system.
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Modem Connections
Updated our TAPI software to provide a 60 second wait for connection.
First Coast - Florida Medicare
First Coast - Connecticutt Medicare
ACS - Florida Medicaid
Trailblazer - Texas Medicare
Trailblazer - Maryland Medicare
Trailblazer - Delaware Medicare
Trailblazer - District of Columbia Medicare
Trailblazer - Virginia Medicare
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First Coast Florida Medicare
Uses new communications user interface for better control over the communications process by the end user. Contains progress bar and version information.
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X-Link EDI
Copyright Date was corrected.
Easy Business Software address was updated in the reseller screen.
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7.0d
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Availity, Availity Government, Florida Mediare and McKesson Receivers
Removed Legacy numbers from all claims transmitted. Please note that all other payors have already had the NPI Only change in effect.
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Gateway EDI, CareVu and Claim Logic
This is only a NOTE - no changes were made: X-Link continues to require and send legacy numbers for these clearinghouses, as they have requested we continue for an indefinite period to require and send both Legacy numbers and NPI.
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7.0c
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New Practice Management System
MediSoft V14 by McKesson
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New Receiver
Claim Logic Commercial Clearinghouse.
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Paper Claims Submission
Added for:
Gateway EDI
CareVu
McKesson
Claim Logic
New Payor Code:
PAPER - Associate your insurance companies to this Carrier Code and these claims will be sent to the Clearinghouse where they will be Print & Mailed for you. Postage Charges may apply. See your contract.
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Default Payor Selections
Modified the methods used to select the default payor to accomidate the New PAPER payor code and simplified the user experience.
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PreEdits
Created a simple method for the user to override the X-Link EDI PreEdits. Simply go into the Failed Claims area and select those claims that failed which you would like to move to Passed Claims. Allows users to override Normal ANSI and Medicare Requirements that may not apply to certain specific claims.
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Claim Logic
Uses new communications user interface for better control over the communications process by the end user. Contains progress bar and version information.
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Carrier Codes Changed !!!
The following Carrier Codes were changed
AmeofNJ => AmeoNJ
Medcom => MedCom
Added new Code
TransAm2 with payerID TSAA2 - TransAme has not changed
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Gateway EDI
Payer ID for BCBS of DC/Carefirst is now 10580.
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Availity/Availity Governmental
Added payors:
25152 - Advantra Freedom
50528 - Universal Healthcare Inc. (St. Pete, FL)
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ANSI Formatting
Corrected final issue with dollar amounts sometimes being sent with a cent digit missing.
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Internet Updater
Changed Primary Atomic Clock used for date time.
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EDI Scheduler
Corrected issue that caused 'MAINFORM is not an object' error when closing the Scheduler.
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Prior Authorization Numbers
Removed the duplicate authorization number that in rare cases was sent in certain claims at the line item level. Now only sent at the claim level.
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Lytec 2006, 2007, and 2008
Corrected issue where Billing History sometimes showed incorrect insurance company as billed. Claims were sent correctly.
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7.0b
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CLIA Reporting
Changed the CLIA numbers to be reported at the claim level and line item levels for situations with multiple CLIA numbers on a single claim.
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ANSI Formatting
Corrected additional issue with dollar amounts sometimes being sent with a cent digit missing.
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7.0a
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TMHP - Texas Medicaid
Changed to NPI Only as required 3/1/08.
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Primary Group Number
Added this inadvertantly omitted field.
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ANSI Formatting
Corrected issue with dollar amounts sometimes being sent without cents.
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Availity/Availity Governmental - GHI HMO
Now sends the required Legacy numbers.
Added payors:
20197 - SUMMIT HEALTH PLAN (VISTA)
37301 - SUMMIT AMERICA INSURANCE SERVICES
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Carrier Relations Setup
Carrier names are now sorted ignoring upper/lower case differences.
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Preedits
Added check for required fields Insurance Company Street and City.
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Carrier Codes Changed !!!
The following Carrier Codes were changed. This corrected issues with the claims for these carriers not being formatted for Medicare or Blue Sheild:
OhiMedcr => OHcareLb Ohio Medicare - Lab
RetRaiMD => RRcareRT Retired Rail Medicare
WyoMdcr => WYcare Wyoming Medicare
VerMdcr => VTcare Vermont Medicare
KanMdcr => KScareTo Kansas Medicare - Topeka
MedMiss => MOcare Missouri Medicare - BC/BS of Arkansas
VerBSd => BCBSVT Vermont BCBS
VmMecd => VTcaid Vermont Medicaid
BCBKCoB => BCBSWAKC BCBS of Washington, King County
KanMdcd => KScaid Kansas Medicaid
KanBST => BCBSKSTo Kansas BCBS Topeka
LovSalnm => LScaid Lovelace Salud Medicaid NM
LovSalud => LScaid2 Lovelace Salud Medicaid SX159
Additionally, the following codes were changed as these carriers were being formatted for Medicare or Blue Sheild when they are actually HMOs:
MCcareS => MedSmart Medicare Smart
EXcare => MedExtra Medicare Extra
BSBSHMO => BSHMO Blue Shield HMO
Fscaid => Med1stSt Medicaid First Star
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Beta Test of Claims Status and Electronic Remittance
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7.0 Initial Release
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Practice Management Systems supported:
Lytec 2006
Lytec 2007
Lytec 2008
MediSoft 11
MediSoft 12
Receivers supported:
First Coast - Florida Medicare
First Coast - Connecticutt Medicare
ACS - Florida Medicaid
TMHP - Texas Medicaid
Trailblazer - Texas Medicare
Trailblazer - Maryland Medicare
Trailblazer - Delaware Medicare
Trailblazer - District of Columbia Medicare
Trailblazer - Virginia Medicare
Availity Commerical Clearinghouse
Availity Commerical with Governmental Option Clearinghouse
CareVu All Payor Clearinghouse
GatewayEDI All Payor Clearinghouse
McKessonHBOC All Payor Clearinghouse
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End of Information
