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Frequently Asked Questions Electronic Data Interchange - Production Submissions
Q. I am in production for the 837 professional transaction fee-for-service and continue to receive the paper RA. On the RA, I receive an error for type of service (TOS). There is no TOS in the HIPAA transaction, so why am I receiving this information on the RA? A. The paper RA is from DHS' current RA process and is not HIPAA-compliant. Because DHS' Medicaid Management Information System (MMIS) still requires a TOS code to be present, DHS had to create a work around. The work around is based on provider type, modifier used/or not and procedure code, etc. If what DHS uses based on this information is not correct, the claim does not pay and an error is created, which is really related to one of the data elements noted in this answer. Eventually this RA report will go away. The HIPAA-compliant adjustment reason codes are the ones that should be used and that you should become familiar with. Q. I did not receive a response 997 or TA1. Should I re-submit my transactions? A. No, contact DHS through the DHS.HIPAATesting@state.or.us email address, or call (503) 947-5347. Q. As a clearinghouse in production, what is the process when a provider has been newly enrolled for our service? Q. Does my password to the mailbox ever expire? A.You will need to change your password every 60 days. This time starts from the time you are assigned a password and you change it for the first time. The SFTP mailbox does not offer any reminders to warn you that your password is ready to expire.
Q. How does Oregon DHS handle scripts that run to submit transactions and/or pick up response transactions? A.Oregon DHS does not have a business decision or policy against running scripts, but we do strongly advise against it. The password requirement typically is forgotten and we get calls to reset them. If the script is not disabled, the password cannot be easily reset and the submitter experiences difficulties. |
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