As part of CMS paper reduction initiatives, the standard paper remittance (SPR) will be discontinued 30 days after the provider has been set up for ERA.

The ANSI 835 version 4010A1 data consists of both the basic and extended character set, with the exception of the * (asterisk) and the > (greater than) symbols. All alpha characters will be generated in upper case.

Please note that the transaction code necessary to pick up ANSI remittance advices is “EDI.” We advise retrieving the ANSI remittances with the script, $BCBSF$ OBTAIN EDI TRANTYPE=ERN $BCBSF$. Information on creating and submitting your script commands is available in the “Guide to Gateway” document.

Medicare will not accept a 997-response transaction from trading partners in response to the retrieval of an electronic remittance advice.

The hexadecimal characters used currently as file delimiters are as follows: Segment 0A (line feed); Element 2A (*) and Sub element 3E (>).

If your software requires characters other than the above, you must notify Medicare EDI of this by selecting alternate delimiters on the Electronic Data Request (EDR) form . You may fax your completed form to (904) 791-6692.

The primary purpose of this free software is to produce a paper remittance advice containing all of the data residing within the ANSI ASC X12.835 Electronic Remittance Advice. The PC-based ANSI ASC X12.835 translator program, PC Print, is an interactive program. It allows viewing and printing of the Medicare Part A Electronic Remittance Advice received by the provider in the form of an ANSI ASC X12.835 Electronic Remittance Advice.

PC-Print has specific requirements for 835 4010A1 files. Before using the PC-Print software you MUST contact the Medicare EDI department at (904) 791-8131, option 2 to ensure your file has the required segment delimiters. Without these delimiters your file will not open in PC-Print. The PC Print environment has limitations on the size of a data file used. It has been determined that a data file with greater than approximately 80,000 segments will not appropriately process in this PC Print Software. FISS does not recommend using files greater than 80,000 segments.

If you are a PC-ACE Pro32® user, you will not need to use PC-Print. Please consult your PC-ACE manual for further information.

The X12 835 version 4010A1 Implementation Guide (IG) contains specific data requirements that must be met to build an Electronic Remittance Advice (ERA). Gap filling is to comply with the IG. As a result, the Fiscal Intermediary Shared System (FISS), will “gap fill” required elements of the X12 835 Version 4010A1 in those situations where the claim received for processing lacked data or contained data that does not meet the data attribute or length requirements necessary for preparation of the ERA. This process will fulfill the minimum data element requirements when sufficient data is unavailable for entry in a required data element. For example, if in SVC01-2, the processed revenue, HCPCS, or HIPPS code is not available, the field will be filled with “LMNOP.”

Listed below are those 835 version 4010A1 elements that could potentially be gap filled due to incomplete data.

If problems or inconsistencies are identified within the Medicare Part A ERA, please contact us at (904) 791-8131, option 2.