How do I get a copy of my Medicare Remittance Advice?

The option to request a duplicate remittance is available through the Claim Status function. Instructions for navigating the IVR are available on our website. Providers who do not have a WPS GHA Portal account or who need a duplicate copy of only a single claim should request one by phone through the IVR.

What is the X12 format?

What is the X12 format? X12 is a standard for Electronic Data Interchange (EDI) developed and maintained by the American National Standards Institute (ANSI) Accredited Standards Committee (ASC). The X12 standard governs the exchange of business documents (e.g., purchase orders, invoices, healthcare claims, etc.)

What are common claim errors?

Common Claim Errors

Mathematical or computational mistakes.
Transposed procedure or diagnostic codes.
Transposed beneficiary Health Insurance Claim Number (HICN) or Medicare Beneficiary Identifier (MBI)
Inaccurate data entry.
Misapplication of a fee schedule.
Computer errors.

Where to find CAS information in MSP form 5010?

Electronically – If you enter an MSP claim electronically (5010 format), the CAS information is reported in Loops 2320 – 2330I as follows:

How to send an electronic claim crosswalk ( 5010 )?

For additional information regarding loops and segments, please access the 5010 Companion Guides ( JL) ( JH) and the 5010 Expectations. When necessary to send documentation (surgical notes, admission summary, etc.) with an electronic claim, please refer to Chapter 11 of the Electronic Billing Guide.

What do I need to know about CGS CAS?

The CGS Claims department will enter the required CAS information based on the submitted documentation. The prior payer’s 835 Electronic Remittance Advice (ERA) typically includes CAS information. The following table provides the “MSP Payment Information” (Map1719) field descriptions and guidance on how to complete the fields.