Empire Medicare Services Multi-Carrier System

Empire Medicare New York is transitioning to the Multi-Carrier System (MCS) on May 02, 2005. As a result, the Companion Guide for HIPAA-compliant 837 X12 4010A1 claim transactions is being updated. In addition, the new MCS Edit Report will replace the Medicare Part B VMS Submitter Report (commonly known as the validation report) for all electronic claim submitters.

One of the major advantages of electronic billing is notification of billing errors within 24–48 hours of claim submission, which affords the provider / submitting entity the opportunity to quickly correct and resubmit rejected claims. Currently, the Medicare Part B VMS Submitter Report is used to report claim rejection information. Due to Empire Medicare Services’ migration to the MCS system, the MCS Edit Report will be the standard validation report. The new report will provide more detailed claim rejection information.

The MCS Edit Report is available approximately 24–48 hours after sending a file that was accepted on the 997 Functional Acknowledgement. The MCS Edit Report will be available for viewing or download for 30 calendar days. Once it is downloaded, it will remain on the file for 11 days. It is important to dial–in regularly to retrieve any available reports to ensure you know whether Medicare has accepted your claims for adjudication or if the claims were rejected and need to be corrected and resubmitted.

Without this report, you will not know whether your claims were received or rejected by Medicare. Claims rejected on this report will not be processed by Medicare or be reported on the Standard Paper Remittance (SPR), Electronic Remittance Advice (ERA), or the Interactive Voice Recognition System (IVR).