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[REVISED] Submitting Paper Claim Forms to National Government Services Due to the Change Healthcare Security Incident

As a follow up to our 2/28/2024 article, Change Healthcare Security Incident, providers have asked if they can submit their Medicare claims on paper claim forms. In order to change to paper claim submissions, providers must submit and receive approval, of an ASCA waiver. Please keep in mind, the Medicare payment floor standards for paper claims is 29 days from the date the paper claim is received, whereas the payment floor for electronically submitted claims is only 14 days.

In our news article on NGSMedicare.com, published on 2/28/2024, we outlined alternate options available to continue submitting claims electronically. Those options are:

  1. Medicare Part B providers can use our provider portal, NGSConnex, for Part B claim submissions. This option is free, and the provider may already be enrolled with NGSConnex.

    Note: NGSConnex does not offer batch claim submission, claims must be submitted one at a time.

    Please click the following link for more information about NGSConnex: NGSConnex
     
  2. Medicare Part A providers can use FISS DDE for Part A claim entry. This option is free, and the provider may already use FISS DDE.

    Note: FISS DDE does not offer batch claim submission, claims must be submitted one at a time.

    Please click the following link for more information about FISS DDE: EDI Enrollment Process User Guide
     
  3. Providers can enroll with a clearinghouse. Please click the following link for more information on EDI enrollment: EDI Enrollment

    Note: Providers submitting claims electronically can have multiple Trading Partner IDs, but from the Remittance (X12 835) perspective, they can only be linked to one Trading Partner ID.
     
  4. PC-ACE free billing software is available for NGS J6 and JK providers only. If you are not a J6 or JK provider, the free billing software must be obtained from your MAC. PC-ACE is a stand-alone claims processing system that enables an electronic submitter to store demographic information, enter and store claim information, and prepare files for Medicare Part A and Part B claims. These files are prepared in the HIPAA-compliant 837 ANSI 5010A2 format.

Please click the following link for more information about the PC-ACE software: About PC-ACE

If your option is to revert to paper claim submission, you must complete the ASCA waiver form and receive approval, prior to submitting paper claims. On the ASCA waiver form, complete the provider information at the top of the form, and at the lower part of the form, under Unusual Circumstances, check the first box that indicates: “A service interruption (e.g., breakdown or interruption in telephone or communications service) Indicate the date the interruption began:” please indicate “February 21, 2024, Change Healthcare.”

Please email your completed ASCA waiver request forms to: NGSASCAWaiver@elevancehealth.com

Please Note: Do not submit your paper claims until you have received confirmation the waiver is being granted. Claims submitted prior to the granting of the waiver will be rejected.

Revised 3/21/2024