NGS & NHIC Transition to Palmetto GBA
Cirius Group, Inc.
Client

The Centers for Medicare and Medicaid Services awarded the Jurisdiction 1 MAC to Palmetto GBA. Part A Medicare claims processing and payments will transition from NGS to Palmetto GBA on August 18th, 2008. Part B Medicare claims processing and payments will transition from NHIC to Palmetto GBA on September 2nd, 2008.

Several steps must be taken in preparation for the new J1 MAC. The first step is to complete the submitter J1 EDI application form. When completing the form, please use the following:

  • Mode of communication: GPNet Asynchronous (check twice)
  • Report Response format: File
  • Data Compression: PKZIP
  • Vendor security ID: 1042JA

New Submitter IDs

About 14 business days after you return the EDI application and EDI enrollment (agreement) forms, you should receive a letter with your new submitter IDs. If you have not received submitter IDs from PGBA after 14 business days, please contact the PGBA Technology Support Center at 866-749-4301.

Once you have received your submitter IDs, please contact the Cirius Group to schedule a day to begin the Early Boarding process. Clients who choose early boarding will send claims to Palmetto GBA, who will forward them to the current Medicare contractor (NGS for Part A, NHIC for Part B). Please note however that the current contractor will continue to process claims, produce 835 remittance advice, and respond to provider inquiries and appeals until the MAC J1 transition dates.

We encourage providers not to wait until the respective deadlines of August 18th and September 2nd to begin sending Part A and Part B claims to Palmetto GBA. To do so invites a certain amount of financial risk.

The Palmetto GBA site is frequently updated with EDI information, FAQs, meeting minutes and more. Transition Workshops will be held in San Francisco on July 7th, 2008 and in Los Angeles on July 10th, 2008. If you are not able to attend either workshop, the content is also available on line.
For more information, please visit http://www.pal mettogba.com/j1

Please direct any e-mail responses or questions to jasonr@ciriusgroup.com or contact us at (925) 685-9300.

Sincerely,


The Cirius Group

phone: 925-685-9300
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