CEDI deadline Moved to June 6

• By David Kopf
• May 30, 2008

Providers in jurisdictions B and C were expecting shortages of midnight oil at local stores this weekend. However, they have been given a short reprieve. Reason being is that providers in those Jurisdictions that submit claims electronically have been rapidly transitioning to submit claims to CMS’s common electronic data interchange (CEDI) so that they can meet the June 1 deadline. However, CMS has just announced that the deadline will be moved to June 6, buying them a little more time.

By next Friday, those providers must have adopted the new system in order to have their claims processed by National Government Services Inc. (NGS), the contractor that handles the CEDI front-end operations for CMS.

Previously, each Medicare jurisdiction had its own protocol for electronic claims submissions. The intent of the CEDI program is to create a single front end for submitting claims electronically. With this change, providers will send all electronic claims and claim status inquiry transactions to CEDI and CEDI will return all electronic front-end reports directly to the submitter.

“Electronic trading partners” in Jurisdictions A and D have already transitioned to CEDI on May 1, and, while the intent of standardization makes a good deal of sense, so far, the reports haven’t exactly been encouraging.

The issue of “volume” is the key sticking point for CEDI, according to Mark Blount, vice president of marketing for HME billing and inventory software provider Brightree Inc. In the move to push the CEDI program through, Blount says the volume of electronic submissions and the technology requirements that would entail were underestimated — to say the least.

“Most folks are having to use dial-up modems to connect, and from what I am hearing, 80 times out of 100 they are getting busy signals,” he explains, adding that when providers do ultimately get through, their transactions might get up to 90 percent of the way complete and then will drop off, forcing them to endure the entire process again.

Another common problem providers submitting CEDI claims are experiencing are password resets. The only way to address those resets is to call the CEDI help line, which Blount says is overwhelmed with calls; and Blount has heard of providers waiting as long as three hours on hold.

To combat the problem, Brightree has created a method to let its users submit their claims in batches via FTP, so that they do not have to deal with CEDI’s modem connections and the time-consuming headaches they entail.

“It’s another example of how the Internet is becoming a backbone in the way providers do business,” Blount says. “Providers are all about providing great customer care. They don't want to deal with technology issues that keep them from doing the things they wanted to do when they got into the HME business in the first place.”