RCPA - Rehabilitation and Community Providers Association


Medicare August 1 J12 MAC Transition
July 31, 2008

The information below received from Highmark Medicare Services and reprinted here for member information, reinforces information distributed previously in the July 25 PCPA Info, Medicare Update regarding Medicare Part A transition to the Jurisdiction 12, Medicare Administrative Contract (J12 MAC). Contact Betty Simmonds with questions.

Attention: SIPP II – PA/MD/DC Part A Providers

J12 SIPP II - Cutover Schedule and Impacts

July 31, 2008

As part of CMS’ consolidation of Medicare operations, Highmark Medicare Services will transition our PA, MD, and DC Part A operations into the J12 Medicare Administrative Contract (MAC) starting Friday, August 1, 2008, and continuing through Monday, August 4, 2008. Although Highmark Medicare Services is the legacy contractor and the new J12 MAC for this workload, there are required system changes that must occur to complete the transition to the new J12 MAC environment. Therefore, there will be system dark days as part of this transition.

Dark Days” beginning 08/02/08 through 08/04/08
In order to complete this transition, Highmark Medicare Services will need to observe system “dark days”. During “dark days,” there will be NO access to the Fiscal Intermediary Standard System (FISS) to conduct claim entry or claim correction, verify beneficiary eligibility and claim status, as well as limited EDI processing.

The J12 MAC transition “dark days” for our PA and MD/DC Part A providers will be Saturday, August 2, 2008 through Monday, August 4, 2008. In the event that a cycle delay or FISS availability delay occurs due to the transition, a listserv email and website notification will be sent with a status update and the estimated time of system and/or EDI report availability.

EDI Processing Availability 08/02/08 through 08/04/08
EDI claims received after 4:00 p.m. EDT on Friday, August 1, 2008, through 4:00 p.m. EDT on Monday, August 4, 2008, will be entered into the FISS processing system Monday night August 4, 2008. These claims will generate EDI reports for retrieval on Tuesday, August 5, 2008.

FISS/HIQA Availability from 08/02/08 through 08/04/08
The FISS will NOT be available on Saturday, August 2, 2008, through and including Monday, August 4, 2008. Therefore, all DDE functions, such as claim entry, claim correction, beneficiary eligibility (HIQA/HUQA), and claim status will be unavailable. Access to FISS/HIQA will resume on Tuesday, August 5, 2008 at 6:00 a.m. EDT.

Customer Contact Center and IVR Availability from 08/01/08 through 08/04/08
Customer Contact Center
: Due to the SIPP II dark day, the Highmark Medicare Services Customer Contact Center will be closed on Monday, August 4, 2008. The Customer Contact Center will be available starting at 9:00 a.m. EDT on Tuesday, August 5, 2008 at the new telephone number 1-877-235-8048. Please refer to the transition newsletter for details.

IVR: Due to the J12 MAC transition, the Interactive Voice Response (IVR) system will NOT be available beginning at 5:00 p.m. EDT, on Friday, August 1, 2008, through Monday, August 4, 2008. The IVR will be available again at 6:00 a.m. EDT on Tuesday, August 5, 2008.

Transition Update
In order to communicate any disruptions during the transition period, Highmark Medicare Services will continue to provide updated communications regarding possible impacts to Medicare Part A providers in PA/MD/DC on our website at www.highmarkmedicareservices.com as well as via our J12 MAC Transition listserv.

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