Summary of change: Effective June 1, 2019, we are updating our provider payment disbursement processes. Change Healthcare and PaySpan will no longer be used for electronic funds transfer (EFT) and electronic remittance advice (ERA) enrollment, and remittances are no longer accessible on their websites. These functions can now be accessed through the following:
  • EFT: If you were enrolled for EFT before June 1, 2019, the enrollment was transferred. You should continue to receive EFT payments. If you are having issues receiving EFT, call the number on the back of the member's ID card:
    • New EFT enrollment: To enroll, go to EnrollHub™, a Council for Affordable Quality Healthcare (CAQH) Solutions™ enrollment tool, at https://www.caqh.org/solutions/enrollhub. Please note the EFT enrollment process can take six to eight weeks. If you have issues enrolling, call the number on the back of the member's ID card.
  • Virtual card: Providers receiving virtual cards from other lines of business for their tax ID will see this additional claim activity delivered as virtual cards.
  • ERA/835: If you were enrolled for ERA before June 1, 2019, the enrollment has transferred. You should continue receiving ERAs through the same clearinghouse you have been using. If you are not receiving ERAs through the same clearinghouse, please call the E-Solutions Help Desk at 1-800-470-9630:
    • New ERA enrollment and change management for existing ERA enrollments will be managed through Availity. If you aren’t registered for Availity, go to https://www.availity.com, select Register and follow the steps. Once logged into Availity, the administrator for the organization will select Enrollments Center in the My Account Dashboard on the home page, select ERA Enrollment in the Multi-Payer Enrollments section and follow the wizard and submit. After submitting the enrollment, you will be notified by email that enrollment is complete and start receiving 835s through Availity as of June 1, 2019. Please note the ERA enrollment process takes up to 48 hours. If you sign up for ERAs through Availity after June 1, 2019, and wish to receive ERAs June 1, 2019, to the date you signed up with Availity, please call the E-Solutions Help Desk at 1-800-470-9630.
  • Providers will have access to Explanation of Payment letters (paper remittances) through the secure Availity Portal, effective June 1, 2019. You must be registered with Availity to view these remittances. If you aren’t registered, go to https://www.availity.com, select Register and follow the steps.
  • Medicaid and Medicare remittance advices have been consolidated.

 

These enhancements offer providers streamlined reimbursement registration tools.

 

The following chart summarizes information about the new processes to enroll in EFT or ERA, or to update EFT and ERA transaction information after June 1, 2019.

 

Process to enroll or update electronic transactions after June 1, 2019 

Type of transaction

How to enroll, update, change or cancel

Contact to resolve issues

EFT only

Use the EnrollHub™, a CAQH Solution™ enrollment tool, a secure EFT registration platform at: https://www.caqh.org/solutions/ enrollhub.

CAQH Provider Help Desk: 1-844-815-9763

 

Call the number on the back of the member's ID card.

Virtual card

Invitations previously sent via letter to selected Tax IDs. Enrollment in EFT would take the place of virtual card.

Questions: 1-800-833-7130

ERA only

Register for ERAs at https://www.availity.com.

Availity: 1-800-282-4548

 

E-Solutions Help Desk: 1-800-470-9630

 

Are providers required to enroll for EFT and ERA?

No, providers are not obligated to enroll for either EFT or ERA and will receive a paper check or virtual card accompanied with a remittance advice.

 

Is there a cost to providers for the changes to the EFT, virtual card and ERA?

There is no cost to providers from Empire BlueCross BlueShield (Empire). Providers should inquire with trading partners and other vendors they work with to understand additional steps or any changes to services.

 

Information and changes to expect

Medicaid and Medicare claim payments and recoveries with claim adjudication beginning June 1, 2019, will be incorporated into one remittance advice for paper or electronic payments. Checks and EFTs from Empire will also be combined. Medicaid and Medicare will be grouped separately on the paper remittance in a section for each product line:

  • The back of the remittance advice will contain specific instructions on how to file Medicare appeals.
  • Medicaid and Medicare claims are identified in the Claim Filing Indicator Code (CLP06 segment) on the ERA/835 for Medicaid with MC and Medicare with MB, MA or 16
  • Effective June 1, 2019, we will discontinue the email notification providers currently receive when an EFT and ERA is issued.
  • The PDF versions of paper remittances will be available on the secure Availity Portal (https://www.availity.com). Both provider and clearinghouse will 835s continue to be received through the EDI process.
  • More information about retrieving copies of remittance advices will be available online. To access our tutorial, Remittance Inquiry Process Guide, go to our provider website and select the Training under Provider Support/Provider Education/Other Training resources. It will be available on June 1, 2019.
  • Non-Federal Employee Program payments under $5 will be held for a maximum of 14 days to allow additional claims to combine to increase the overall payment amount.
  • These changes will ensure efficiency and consistency between professional and facility claim payments.
  • The Automated Clearing House batch header is changing. The payee name that appears on the EFT statement is changing and will be easily identifiable. This change does not impact payment to you in any way. You will now see EMPIRE BLUE 05C.

 

How do I access historical ERAs from Change Healthcare and PaySpan?

We are in the process of migrating all historical remittance advices to the secure Availity Portal (https://www.availity.com). We will notify you when the migration is complete. Please continue to use Change Healthcare and PaySpan to receive historical paper remittances prior to June 1, 2019.

 

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April 2019 Empire Provider Newsletter