Using Modems for Medicare Connectivity

MEDTranDirect provides connectivity between healthcare providers and all the Medicare contractors (MACs).  Through this connection, providers can have access to the Direct Data Entry (DDE) or FISS system, the ability to send claim files and receive response files like the 835 and 277CA, and connection to the Medicare eligibility system (HETS).

The first two services have been available for almost thirty years.  When they were introduced, access to these systems was achieved through a modem, phone line, and a remote terminal to the IBM mainframe computers running these services.  Now, decades later, this technology is still prevalent among providers who are still using the same methods to access this information and conduct these transactions.  Although many users have replaced the remote terminal with an emulator that can run under Windows on an existing PC, the technology connecting this emulator to the MAC systems still exists and is still supported by many MACs today.

modem blog

Continue reading

Improving the Processing of NOEs and NOTRs for Hospices

As a vendor of eligibility processing services and a NSV (Network Service Vendor) for the Medicare HETS eligibility system, we have a vested interest in the capability of these systems to provide current and valid information. Through the HIPAA transaction for eligibility data (ANSI 270/271), we send requests to these systems for eligibility data for specific patients. Through a real time response, we can provide detailed information about the current status of this patient with the selected payer. This process involves converting the data returned by the payer into a report or entering it into a database.  In this process, we are the “messenger”. The content we provide is completely dependent on the quality of the payer response.

In some cases, these responses can be incomplete or inaccurate.  When this happens, we often get support incidents where providers complain that we are providing incorrect data. Most of the time, they are technically correct, but the issues they present as problems are beyond the ability of these payer systems to accommodate given the way this data is collected.

NOES and NOTRS Continue reading