CMS mandates PAYERID codes

Every healthcare payer will have a unique 8 digit number, with NO EXCEPTIONS.

This information is only for providers. If you think that the PAYERID is just another code for you to remember and a way to rip you off, we do not know if you are right or not. We do believe that this action by CMS has the potential of being one of the greatest moves that they have made since they decided to stop supporting 40+ electronic formats. We think this is great!!! Now instead of typing in the name of the secondary payer and having an OCNA code (Transamerica, Southern California Medicare contractor in the past) or a Medigap code (most other Medicare contractors) (all of which are different and unrelated) you will have a single, unique code to refer to any (and ALL) payers whether it is an insurance carrier, TPA (third party payer), self-insured employer or any of the other variations.

We here at Stratford see this as one more great rule coming from CMS. The only thing we see wrong with it is that it took so long. We support this completely.

Some providers will not agree with us because these changes require them to change. It requires us to change also and it is costing us plenty of development dollars. We are willing to do it because it will make our program better and easier to maintain since we have customers in all states. These changes will lower our costs and we will pass it on to our customers.

Great changes from CMS...

Only two formats will be accepted for electronic claims

Every provider will be issued a single, unique ID instead of State IDs, UPINs, PINs, etc., etc.

Every healthcare payer will have a unique 8 digit number, with NO EXCEPTIONS

Now that we see that CMS is getting healthcare claims processing on the right track, we want even more:

1. only one electronic format (we prefer ANSI X.12) (get rid of National Similar Format forever) I wonder if CMS realizes that every contractor has already created exceptions and differences in the way the ANSI file is created? Does CMS know that every payer requires a different transmission protocol: some need JCL, some don't. Some require 80 byte records (yes that is right, 80 byte records in a beautiful varible length record layout like ANSI X.12). Does CMS know that it is not possible to create a single software program that will transmit claims to all the states in the United States?? There are still many taxpayer dollars to be saved.

2. find a way to accept virtually all attachments electronically. (We know this is coming soon)

3. stop paying for paper claims or charge the costs for processing to the provider. Pay the paper claims last with money that is left after paying all electronic claims. Get rid of OCR equipment and faxed claims. It really does not work that well and we all know it. Direct transmission is not new technology. It works and it is cheap. Any provider can buy a very powerful computer to do the billing and run his/her office for less than $2,000. Really, this is nearly the year 2000, make the move. For most of the providers who do not now transmit, this is the only way. All providers are taxpayers (aren't they?) All taxpayers want the Medicare program to be successful and stop wasting money. Provide healthcare with the money, don't waste it processing claims.

All Stratford customers have the necessary software to transmit now. We want them to start today. Most of them already have started.

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Last modified: 09/04/13