Redesigned Claims Area

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.

 

MAC Jurisdiction 8 Implementation to Start

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.

 

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

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.

 

Interactive Voice Response (IVR)

Interactive Voice Response (IVR)

The IVR telephone system provides a wide range of useful information to our provider community. To assist users with navigating the IVR as seamlessly as possible, WPS Medicare put together a few helpful hintsAdobe Portable Document Format.
For example, you can bypass the up-front message(s) by saying “main menu.” If the IVR is having trouble recognizing what you say, enter the information using your telephone keypad instead, and saying “main menu” will always bring you back to the beginning of the call flow.

 

Providers Using Direct Data Entry (DDE) Deleting and Rekeying Lines on Adjustments/Returned Claims

Providers Using Direct Data Entry (DDE) Deleting and Rekeying Lines on Adjustments/Returned Claims

When entering an adjustment to a claim that has a line(s) that has been denied or rejected due to a keying error, providers utilizing DDE should delete the line by placing a D over the first zero of the line to be deleted, press the Home key, press the Enter key and rekey the line with the modifications. Adjustment claims that are not deleted and rekeyed will edit in the system and can cause an out of balance situation and the claim will not post to an Electronic Remittance Advice (ERA).

 

Claims Tab MAC J8 Implementation 5010 IVR Direct Data Entry (DDE)

Tips for First Time Visitors

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Are you new to the WPS Medicare, MAC Part A website? If so, please allow us to introduce you to the site and the various tools we have available to assist you.

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Save Time, Save Money

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Go Green and get your payments and remits faster by signing up for electronic funds transfer (EFT) and electronic remits

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Claims Denials and Rejections

System related claims processing/payment alerts reported to CMS and the Fiscal Intermediary Standard System (FISS) maintainer for research and correction. Please refer to these important messages before contacting our Customer Service Area.

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C-SNAP

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WPS offers C-SNAP, a FREE 24/7 Internet portal that provides real-time patient eligibility and claim status information, and the ability to view and print duplicate remittance advices on demand.

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Site Map

The Site Map is a menu of the main pages on our website. It shows the overall website layout allowing providers to select any of the links for immediate access to a specific page. You can access the site map from the link in the upper right corner of any page.

How and when to use site map - Learn more >>

CERT

Stop refunding money, WPS Medicare is dedicated to helping you receive correct payments and avoid errors that are identified by the Comprehensive Error Rate Testing (CERT) contractor.

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Provider Specialty and Service-Specific Information

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Visit the "Provider Specialties/Services" web pages to view information for over 20 specialties and services from Ambulance to Urology.

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Call Center Status

  • C-SNAP: Available
  • Customer Service : Available
  • EDI: Available

System Status

  • C-SNAP: Available
  • FISS: Available
  • IVR: Available