Part B EMC Batch Detail Control Listing

• 997 Transaction Acknowledgment - These reports are front-end file confirmations, which are created as Medicare receives the claim file. Once Medicare has received your file, it is imperative you obtain this report. Your software vendor should help you understand how to obtain and read the acknowledgements. Medicare’s EDI department can also assist with understanding why the file rejected; call 904-354-5977 Option 2.

• Batch Detail Control Listing, also known as Medicare’s Second Day Reject Report - After the file has been accepted and a Transaction Acknowledgment has been generated; another set of editing takes place prior to Medicare B processing. This level edit can be one claim, a batch, or the whole file, depending on the level of edit that is hit. It is imperative you obtain this report the next business day. A Pre-Pass edits listing

is available for download on our Web site (An updated listing is posted with each quarterly release.). Your software vendor should help you understand how to obtain and read these reports with the assistance of this document. Medicare’s EDI department can also assist with understanding the rejects; call 904-354-5977 Option 2 for Florida Part B.

• All claims passed to the Medicare B processing system are processed according to Medicare B guidelines.

Important Information When Resubmitting “Batch Detail Control Listing” Rejected Claims

• Corrected claims should always be resubmitted electronically

• Entire batch rejects: If the entire batch rejected as indicated on the Batch Detail Control Listing, make the necessary corrections. Before resubmitting them electronically, ensure you do not transmit an exact duplicate batch. You can do this by altering the totals, adding additional claims, or splitting the batch.

• Individual claims reject: If you receive a Batch Detail Control Listing that indicates only certain claims rejected, it will list the detail(s) that caused the reject. After you correct the specific detail, the entire claim needs to be resubmitted, not just the detail(s)/line item(s) causing the reject. If you do not resubmit the entire claim, the other details without errors will not be processed for payment.

Before You Contact the Medicare EDI Department

• Research the concern you have before contacting the Medicare EDI Department. Most of the time by reading the “Error Number” and “Field Contents” on the Batch Detail Control Listing and comparing it to data in your computer, you will be able to determine what caused the reject, correct the error and resubmit the claims without needing additional assistance.

• Be prepared when contacting the Medicare EDI Department by having the following information:

• “Submitter ID” located to the left of the submitter’s name and address on the Batch Detail Control Listing. If you submit through a clearinghouse, you will not have a submitter ID; you should call the clearinghouse for assistance. If you have the error number from the report, Medicare EDI can always explain what the error means, but they can never go into the clearinghouse’s file without them on the line.

• “Process Date” located under the submitters address on the Batch Detail Control Listing.

Hints to Prevent Rejects on Batch Detail Control Listing

• Never use special characters (dashes, $$, spaces, periods, etc.).

• Always use uppercase characters.

• Use appropriate “O” (alpha) or “0” (numeric) characters in specific fields.
Note: the first nine positions of the HIC numbers should always be numeric.

• Ensure that all providers have an NPI.