Missing Florida Medicaid Claim Rejections at Clearinghouse

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Gavin Walker
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Missing Florida Medicaid Claim Rejections at Clearinghouse

Post by Gavin Walker » Thu Aug 21, 2008 9:09 am

Details :
As Florida Medicaid transitioned their transaction processing from ACS to EDS on June 23rd, EDS has been having programming issues on their end creating a specific report to send to your clearinghouse. This report is called a 277 (much like ERAs are called 835s) and is one that tells you whether or not your Provider ID/NPI is matching what is listed in Florida Medicaid’s system. This is a vital piece of information as any claims that contain Provider ID/NPIs that do not match what EDS has in their system are going to reject. Up until now, these rejects were not being communicated and the claims were being put in a pending status. Now that EDS is able to create these 277 reports, they have informed us that the provider must log into EDS’ portal and allow those reports to be routed to your clearinghouse (much like what was done with the ERAs when this transition first occurred). To have those 277s sent to your clearinghouse from EDS and have those messages parsed out to the Individual Provider the following steps must be completed:

Step 1: Access the payer’s portal at https://home.flmmis.com: Initially, when each provider enrolled with Florida Medicaid to receive a Provider ID, they were given access to this payer portal with a specific login and password. If you no longer have your access information, please contact Florida Medicaid to retrieve this information by calling 800-289-7799 and selecting Option 5 to get to Provider Services. Once logged in, you will need to select Account Management

Step 2: Add your clearinghouse as an Agent: Once you have reached the Account Home, you will need to click on Add Agent at the top of the screen (If you have already gone through this step for ERAs in the past, you’ll want to click on View Agent Roles and then click on Manage Agent as your clearinghouse should already be listed as an Agent and then skip to step 3).

This will then bring you to the Add Agent screen. You will then enter the E-mail address linked to your clearinghouse (for MedAvant it is [email protected], check with your clearinghouse for the specific e-mail address). Once the E-mail address has been entered, click Search and your clearinghouse will be listed as an Agent. You will then need to click on Manage Agent.

Step 3: Modify Agent to allow for 277 Download: The next screen to show up will allow you to modify settings for the agent on the portal. You will need to click the Select hyperlink for Florida Web Portal listed on the left hand side and then you will need to select Download 277 listed on the right hand side.

Once those steps are completed, click Save Changes.

After these 3 steps have been completed, all future 277 reports will be delivered to your clearinghouse and they will parse out any rejection message and send them directly to your provider reports.

Submitter Actions:
Update submitter profile following the above steps so that your clearinghouse will receive your 277 rejections
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

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