If you are currently using any of the plugins listed below, you need to download and update your database with the latest plugins.

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1 Product: VisEDI Released: 12/07/16 If you are currently using any of the plugins listed below, you need to download and update your database with the latest plugins. Plugin Name As Seen in Centricity VIS FQHC /SFS Approval VIS FQHC/SFS Approval MC VisAvaility File Processing Cahaba Institutional Claims Creator VisClaims File Processing CR VisEligibility CR COMC 837 Institutional Claims Creator CYS 837 Institutional Claims Creator EHG 837 Dental Claims Creator HIMC 837 Institutional Claims Creator HMSA 837 Institutional Claims Creator MBCMC 837 Institutional Claims Creator VisClaims Professional PI VisClaims File Processing PI MEMC 837 Institutional Claims Creator MNMA 837 Institutional Claims Creator MOMC 837 Institutional Claims Creator Navicure 837 Institutional Claims Creator NCMC File Processing Noridian 837 Institutional Claims Creator NYMC 837 Institutional Claims Creator TXMC Institutional Claims Creator VisInstitutional Claims Creator Zirmed 837 Institutional Claims Creator Plugin Name As Seen in VisEDI Installer License CYSFQHCApproval CYSFQHCApproval Availity837 Cahaba837 ClaimRemedi COMC837 CYS837 EHG837 HIMC837 HMSA837 MBCMC837 MBCPI837 MEMC837 MNMA837 MOMC837 Navicure837 NCMC837 Noridian837 NYMC837 TXMC837 UGSUB92837 Zirmed837 Insurance carriers are frequently making changes to requirements for FQHC claims, requiring Visualutions to update their EDI claim and eligibility file creators. We also periodically add enhancements to the new releases / updates. To stay current with all carrier requirements such as Medicare FQHC PPS claim filing, Medicare A RHC claim filing, eligibility response changes from carriers, and remittance processing please be sure to download and install all EDI plugins for which you have a license. Once the VisEDI installer is downloaded and installed on the server, run update.bat to update all workstations, Citrix and Terminal servers to assure that users are accessing the most current plugins.

2 CYSFQHCApproval Version: FQHC Approval / Sliding Fee Approval New functionality/setting added for TN Health Link Carriers, approval adding Encounter procedures once monthly. Must select setting, save and re-open approval for TN HealthLink tab to appear. Correction of approval failure when Insurance Carrier is not listed as one of the carriers listed on Patient Demographics (not required when case is created for Workers Comp)

3 Corrected Error message(s) being reported when Valid Medicare A RHC procedures are missing from a visit. Modifications to requirements when a Referring provider is not credentialed for specific procedures. Modifications to approval process in finding subsequent visits after single visit fail during the VisApproval. Availity837 Version: Electronic Remittance /835 Processing Response File Processing / 277 Processing /Payer Reports Modifications to processing of 835 remittance files when the date of service was no longer reported by some payers at line item level. Additional enhancements to look for additional information in REF*2U segment if same payer literal is being sent and carrier has different payer ID s for each line of business (Medicare MCO versus Medicaid MCO). Additional reporting of data returned in 277 Payer reports (individual claim rejection) each STC segment note is reported on separate line (ease in reading each message) Cahaba837 Version: ClaimRemedi Version: Remittance Processing Eligibility

4 Modifications to processing of 835 remittance files when the date of service was no longer reported by some payers at line item level. Additional enhancements to look for additional information in REF*2U segment if same payer literal is being sent and carrier has different payer ID s for each line of business (Medicare MCO versus Medicaid MCO). Enhancement to process Electronic Remittance when Encounter is added to visit and maintains balance, Encounter Code is not reported to carrier and payment is made on the one of the procedures that qualifies the visit as a face to face visit (Maryland Medicaid/MCO). Payment will now be posted to the CPT returned and Encounter adjusted back off the visit. Additional labels with more meaningful descriptions returned in the EB segments. COMC837 Version: CYS837 Version: EHG837 Version:

5 HIMC837 Version: HMSA837 Version: MBCMC837 Version: MBCPI837 Version: Professional / CMS1500 Electronic Remittance /835 Processing Suppression of reporting of Sliding Fee Carriers on claims (uses setting from approval form on Sliding Fee carrier) New professional file creator setting Files to MI Cares carrier requirement changes to the header of the 837 claim file(s).

6 Modifications to processing of 835 remittance files when the date of service was no longer reported by some payers at line item level. Additional enhancements to look for additional information in REF*2U segment if same payer literal is being sent and carrier has different payer ID s for each line of business (Medicare MCO versus Medicaid MCO). Enhancement to process Electronic Remittance when Encounter is added to visit and maintains balance, Encounter Code is not reported to carrier and payment is made on the one of the procedures that qualifies the visit as a face to face visit (Maryland Medicaid/MCO). Payment will now be posted to the CPT returned and Encounter adjusted back off the visit. Additional enhancement to find appropriate CPT when REF*6R (Line Item Control number) is not returned by some payers. MEMC837 Version:

7 MNMA837 Version: MOMC837 Version: Correction to reporting the multiple CL1 segments when overrides were populated. Navicure837 Version: NCMC837 Version: Electronic Remittance / 835 Processing Fixed the display of Remittance Settings.

8 Noridian837 Version: Institutional / UB04 Medicare A RHC new claim filing requirements (effective 4/1/2016) that include rollup to additional CPT s other than just E&M codes. Ignore Suppress Revenue Code if Medicare A / RHC flag is set and date of service is after 4/1/2016 NYMC837 Version: Institutional / UB04 Additional validation on same date of service visits with different value codes, was rejecting when second set of value codes were batched separately at a later date. Change to use cusecsugsgetpatientvisit stored procedure in place of EcsUGSGetPatientVisit Corrected Invalid Diagnosis error when batching same date of service. Additional validation on same date of service if second visit has not been approved and does not contain a value code. Updates to handle when site does not have any active carriers selected in the patient demographic when combining same date of service claims (Order for the claims uses the Active carriers first and then adds all additional carriers from visits /requires new VisCHC). Update to batch same date of service if site elects to use Cases for each visit to assign correct carriers to claims. TXMC837 Version:

9 UGSUB92837 Version: Remittance Processing for Medicare A RHC s Institutional / UB04 Medicare A RHC 835 Remittance processing was not always finding the appropriate Remittance settings if there were more than one carrier on the visit or if the Secondary payer remittance was applied /posted first. Medicare A RHC 835 Remittance processing - Corrections to how the CO 45 amounts were being calculated and populated in the Line Information fields. Corrected Invalid Diagnosis error when batching same date of service. Corrected issue when batching Medicare A Therapy claims when all tickets (for single patient for the month) are in File Rejected status. Only visits in Approved will batch. Zirmed837 Version: