EDI DME MAC PRODUCT INFORMATION

AdminaStar Federal, in conjunction with The Centers for Medicare and Medicaid Services (CMS), strongly encourages electronic data interchange (EDI) transactions. As a company, we offer products and services in the EDI environment beyond the submission of electronic claims. To maximize the benefits received as an electronic submitter, incorporate all of our EDI tools in your daily business routines.

E-Commerce Consultants:

AdminaStar Federal's E-Commerce Consultants have years of combined Medicare and EDI experience. They use their expertise to advise suppliers on maximizing the EDI tools offered at AdminaStar Federal. These consultants provide education on EDI and HIPAA (Health Insurance Portability and Accountability Act). They assist suppliers when making decisions associated with the electronic environment and work closely with software vendors, billing services and clearinghouses to provide effective communications. You can contact your E-Commerce Consultant using the information below:

To Download the latest version of the EDI Brochure click here

Claim Status Inquiry:

Claim Status Inquiry (CSI) provides suppliers the capability to view Jurisdiction B DME MAC claims submitted to AdminaStar Federal as they appear in the Medicare processing system. Through this system suppliers are eligible to view claims for a specific supplier number, HIC number or dates of service. This will include paid, denied, pending, assigned and non-assigned claims. Twenty-seven months of claim history is maintained and accessible through CSI. Beneficiary Eligibility is also available through CSI. Filing claims electronically is the only requirement necessary to sign-up for CSI.

To access the CSI agreement form, click here.

Electronic Remittance Advice:

Electronic Remittance Advice (ERA) enables suppliers to receive their remittance sooner than on paper. Along with faster receipt, some software vendors have developed the capability to post the ERAs automatically. The automatic posting process is reliable and efficient. Check with your software vendor to see if you have this capability. Filing claims electronically is the only requirement necessary to sign-up for ERAs.

To access the ERA agreement form, click here.

For more details on ERA, click here.

Electronic Funds Transfers:

Electronic Funds Transfer (EFT) allows automatic deposit of claims payment into a bank account specified by the supplier. When EFT is coupled with ERA, the advantages include quicker receipt of funds and notices, eliminated trips to the bank and the time savings of a manual process.

To access the EFT agreement form, click here.

Express Plus

Express Plus is PC compatible software with the ability to electronically transmit Jurisdiction B DME MAC and Medicare Secondary Payer (MSP) claims. By utilizing Express Plus Software, Medicare claims are paid following the 14th day of processing versus 29th day for paper claims. User managed tables contain vital information such as: patient demographics, UPIN number and name, Facility name, and Medigap ID. These tables assist the user in creating claims quickly and accurately.

The following is a list of minimum system requirements needed to use Express Plus:

• 50 MB hard disk space
• 32 MB RAM
• Windows 95 or greater(Express Plus will not work on Windows 3.1)
• 386DX or higher processor
• 9600 - 28800 baud rate modem (Express Plus will not work with a "cable modem" or a DSL line.)
• Printer
• CD Rom

Access the enrollment forms here.

Medicare Remit Easy Print (MREP):

Are you still using the Standard Paper Remittance (SPR)? Save TIME and MONEY by taking advantage of FREE MREP software available for viewing and printing the HIPAA compliant Electronic Remittance Advice (ERA)! The MREP software gives providers the following abilities:

• Easy navigation and viewing of the ERA using your personal computer;
• Print the ERA in the Standard Paper Remittance (SPR) format;
• Search capability that allows providers the ability to find claims information easily;
• Print and export reports about ERAs including denied, adjusted and deductible applied claims;
• Easy-to-use method to archive, restore, and delete imported ERAs

Providers can view and print as many or as few claims as needed. This will be especially helpful when you need to print only one claim from the remittance advice when forwarding the claim to a secondary payer. This FREE software can save you time resolving Medicare claim issues. Take advantage of the MREP features unavailable with the SPR.

For more information on MREP or to download the MREP software, click here.

EDI List Serve

An EDI List Serve is available. This is the fastest way to stay informed of EDI news and updates. Once subscribed, you will receive e-mails containing the latest information.

To subscribe to the EDI List Serve, click here.

Connectivity Alternatives/Network Service Vendors:

AdminaStar Federal offers the network service vendors, IVANS, Nebo Systems and VisionShare, to provide an alternative method of communication to EDI Services. These vendors offer services and benefits that include connection to AdminaStar Federal for submission and receipt of HIPAA transactions and access to Claim Status Inquiry (CSI). To receive additional information on the services provided from these network service vendors and pricing structures, use the contact information provided below.

Support

Our EDI Help Desk consists of highly trained experts in the field of EDI. They are available to assist suppliers with any electronic needs.

1-877--273-4334
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Hours of operation are as follows:

8:00 a.m. - 4:00 p.m. (Eastern Time) Monday - Friday
NOTE: The EDI Help Desk will be open until 6:00 p.m. ET for Password Reset Calls only.

The EDI Help Desk can be contacted via email at NGS.EDI.DMAC@anthem.com.