decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Medicare_Carriers_Manual / 3025 / 3025._NATIONAL_STANDARD_FORMAT_MAINTENANCE_PROCEDURES
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Article Overview
This article explains the maintenance process for the National Standard Format used in Medicare electronic media claims and electronic remittance advice transactions. It outlines the responsibilities of carriers, central office staff, and regional office EDI coordinators, along with the general workflow for submitting, reviewing, coordinating, and announcing format changes. It is relevant to billing operations, EDI coordination, and organizations working with standard electronic transaction formats.
Why This Topic Matters
Organizations that handle Medicare electronic transactions need to know which office manages format maintenance, how updates are requested, and where notifications and implementation responsibilities fall. This helps readers understand the administrative process behind NSF changes and the roles involved in keeping electronic transaction formats current.
Article Sections
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3025. NATIONAL STANDARD FORMAT MAINTENANCE PROCEDURES
Overview of the maintenance process for the National Standard Format and the organizations involved in managing updates. The section also introduces the general change-request workflow for electronic transaction formats.
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A. Carriers
Responsibilities assigned to carriers in relation to change requests, vendor communication, release implementation, and coordination support. The section addresses operational duties tied to maintaining awareness of NSF updates.
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B. CO - Division of Health Care Information Systems Standards (DHCISS)
Functions performed by the central office unit responsible for evaluating requirements, coordinating releases, and handling change requests. The section focuses on the administrative role of the office that oversees NSF maintenance.
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C. RO EDI Coordinator
Responsibilities of the regional office EDI coordinator in receiving requests, forwarding them, and communicating release information. The section describes the coordination role between carriers and the central office.
What You Will Learn
- How the National Standard Format is maintained
- Which organizations participate in NSF maintenance
- How change requests move through the maintenance process
- What general responsibilities carriers, central office staff, and RO EDI coordinators have
- How updates and releases are communicated to affected parties
Who Should Read This
- Medical billers
- EDI coordinators
- Carrier operations staff
- Healthcare administrators
- Organizations submitting electronic claims or remittance transactions
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