Delaware Medical Assistance Updates 1/11/2012 – 1/20/2012

01/20/2012: Delaware Medical Assistance – DEMCD_P5 – If you are receiving the following rejection on your 999 Functional Acknowledgement Report, click the following link for instructions on downloading an updated billing program: Downloading Billing Programs.

Seg.       Loop       Error
NM1       2310       Implementation Dependent Segment Missing

Please Note: The Transaction Set is not R = Rejected but rather E = Accepted But Errors Were Noted.

For all charges where the Place of Service is 12 – Home you must make sure that the Patient’s +4 zip code is entered. +4 zip codes can be obtained by going to www.usps.com and clicking Look Up a Zip CodeTM.

01/11/2012: Delaware Medical Assistance – DEMCD_P5 – With an ANSI 5010 submission you will only receive a 999 Functional Acknowledgment Report and a TXN – Transaction Status Report. Click the following link for instructions on downloading these response reports from Delaware Medical Assistance: Downloading Delaware Medical Assistance Response Reports.

If you are not receiving a 999 Functional Acknowledgment Report or a TXN – Transaction Status Report from Delaware Medical Assistance for your ANSI 5010 submissions they are experiencing a problem with the delivery of these reports to some submitters. Please call HP Provider Relations at 800-999-3371 to be sure your Submitter ID is setup for ANSI 5010. If your Submitter ID is setup for ANSI 5010 you will need to wait for Delaware Medical Assistance to fix the report delivery issue.

If your office is receiving a REJ – Rejected Transaction Report for your ANSI 5010 submissions from Delaware Medical Assistance please call HP Provider Relations at 800-999-3371 to be sure your Submitter ID is setup for ANSI 5010. The REJ – Rejected Transaction Report can be found under the EBX Reports heading under the EE Reject Reports subheading on the Delaware Medical Assistance website (www.prod.exb-eds.com). If downloaded the report is not in a readable format.