Emdeon Patient Eligibility Announcements

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04/19/11: Delta Dental of Minnesota

Emdeon Business Services is pleased to announce, effective immediately, DDMN now accepts the Dental Real Time Eligibility HIPAA 270/271 transaction through Emdeon Business Services.

DDMN provides a detailed benefit 271 response.   NPI is required on the request and will be returned from the payer.

Delta Dental of Minnesota – CDMN1 (Includes the following payers):
  - Zenith Administrators – R7001
  - Wilson McShane – R7002
  - Benefit Inc – R7003
  - Flex Compensation – R7004
  - Medica of Minnesota – CX026
  - Delta Dental of North Carolina – 56101
  - Delta Dental of North Dakota – CDND1
  - Delta Dental of Nebraska – CDNE1
  - Securian - 93742
  - Empire BCBS - CBNY1
  - DeCare - 07035

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05/17/10: Americhoice NJ/PA (DBP) and UHC (DBP)

Eligibility check is now available for payer ID 52133 – AMERICHOICE NJ (DBP), AMERICHOICE PA (DBP), and UNITED HEALTHCARE MS (DBP). A yes/no response is returned.  Please note that the insurance company name must exactly match one of the above 3 names in order to receive a correct response.  If you wish to use this feature please check the insurance company name in Suzy and change it if necessary.

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04/28/10: Massachusetts Medicaid

Effective immediately, MA Medicaid no longer requires a Payer Assigned User ID or Password for Real Time Eligibility Inquiries.

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04/01/10: Northeastern Payers

Please be advised the recent record rainfall amounts and flooding in the Northeastern US may impact the normal operations and EDI processing schedules of some Payers in the region (especially Rhode Island). Some Payers may temporarily delay or suspend processing EDI claims, ERA, claim status, and/or real-time transactions.

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09/23/09: Washington Dental Service

Washington Dental Service, Payer ID 91062, is now live for Real-Time Eligibility Checks.   WDS does return dental benefit information when this check is performed.

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09/15/09: Changes in Michigan Medicaid Eligibility Checks

Effective 9-15-09 Michigan Medicaid began accessing their CHAMPS system for eligibility information.
This payer change has had the following impact.

Office MUST send the NPI as the primary identifier in the transaction unless they are deemed an exempt provider by MI Medicaid.

MI Medicaid member IDs must be sent with 2 leading zeroes. The ID will be 8 numeric characters with 2 leading zeroes (e.g. 0012345678)

In addition, we have been advised providers who are not setup correctly within the CHAMPS system will not receive a 271 response. Providers MUST contact MI Medicaid to update their provider information accordingly.

MI Medicaid CHAMPS access, contacts and additional information is available at
http://www.michigan.gov/mdch/0,1607,7-132-2945_5100-145006--,00.html

Emdeon will be making the following changes to our Real Time Eligibility transactions to accommodate the payer’s changes. I will notify you when complete.

- Send NPI only to MI Medicaid.
- Add the leading zeroes to the member ID if we receive an 8 character member ID.

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07/10/09: Dayton Area Health Plan DBA CareSource

Emdeon Business Services is pleased to announce, effective immediately, CareSource now supports the Emdeon Real Time Eligibility Check.

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