MAC Jurisdiction 8 Implementation to Start

CMS recently instructed WPS to begin the implementation of MAC Jurisdiction 8. For this contract, WPS will administer the Part A and Part B benefits for Indiana and Michigan. While specific timelines are not yet available, WPS is already working to ensure a smooth and seamless implementation.

As more information becomes available, we will use our website, eNews, and other distribution channels for updates. WPS looks forward to serving the Jurisdiction 8 beneficiaries and provider community.

Medicare Physician Fee Schedule Database

WPS Medicare published the revised 2012 Fee Schedules (Legacy Part B and J5 MAC Part B) on January 5, 2012. These files include the PAR and Non-PAR amounts as well as the limiting charge. If you are looking for information on status codes, relative value units, global surgery, physician supervision of diagnostic procedure, or other fee schedule indicators, please refer to the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule (PFS) Relative Value Files(external link).

eRx Payment Adjustment (1% Reduction)

Eligible professionals who met the eRx payment adjustment inclusion criteria, but failed to meet the reporting requirements in 2011, may receive the 2012 eRx payment adjustment (1% reduction) starting January 1, 2012. Check your remittance advice for the term "LE", Claim Adjustment Reason Code (CARC) 237, and Remittance Advice Remark Code (RARC) N545. More information is available in the CMS Special Edition MLN Matters article 2012 Electronic Prescribing (eRx) Payment Adjustment: Assessment and ApplicationAdobe Portable Document Format .

Is your vendor, billing service, or clearinghouse ready for 5010?

WPS Medicare maintains a listing of contact information for vendors, Network Service Vendors (connectivity vendors), billing services, and clearinghouses that have tested their product/service with Medicare and have been approved for format 5010. We encourage you to access this listing by visiting our website(external link) and selecting Electronic Media Claims Approved Vendors, Billing Services, and Clearinghouses on the right hand side of the page.

Redesigned Claims Area

In an effort to improve your website experience, we have recently redesigned the Claims area of our website. You can now access information on claims submission, claims processing, claim denials, and claim rejections by selecting the "Claims" tab from the top navigation. Please note, you may have to recreate any bookmarks you had saved for claims-related information.