CAQH EnrollHub Sunsetting
CAQH will be sunsetting their enrollment services, and Change HealthCare PES will be the new Enrollment provider. We are targeting October for deployment of the new platform and services. More information to follow, as we get closer to deployment. Continue to enroll with CAQH until otherwise noted.
Incomplete processing of Medicare files July 30—Aug. 2
Due to an update on the Medicare server, some of the files received for Medicare J5A, J5N, and J8A between July 30 and Aug. 2 did not complete processing. WPS is unable to identify the specific claims or trading partners that were impacted. If you submitted claims between July 30 and Aug. 2 that are not in the FISS system or for which you have not been paid, please rebatch and resubmit the files. (Note that duplicate rejection Explanation of Benefits will produce for any claims that processed successfully when originally submitted.)
The WPS Bulletin Board System (BBS) and Secure-EDI will be discontinued effective Oct. 1, 2021. If you submit or receive X12 transmissions via BBS or Secure-EDI, you will need to switch to WPS Community Manager and use WPS Gateway Express.
Note: This does not effect Family Care Spreadsheet Submitters.
Alert—code set rejection errors
WPS experienced an issue with a variety of code sets rejecting incorrectly from July 24—July 28, 2021. The issue has been resolved. If you had any claims with codes that rejected incorrectly, you will need to resubmit them.
We apologize for the inconvenience.
Due to the volume of ERAs and EFT enrollments WPS receives, processing could take up to 30 days after WPS receives an enrollment. Our dedicated team works diligently to process enrollments in the order they are received. We appreciate your patience and will continue to provide the best service possible to meet the demanding needs of our providers.
Attention: Veterans Affairs (VA) Community Care Network (CCN)
Please be aware of the upcoming changes for VA claims submitted on or after June 9, 2021. If you submit through a clearinghouse, contact your clearinghouse to determine what changes are needed for submission of electronic transactions. If you currently submit directly to WPS, you will have the option to send through Availity’s Basic Clearinghouse option. If you submit paper claims, starting June 9, 2021, send them to the new address:TriWest VA CCN Claims
The WPS Corporate Services–EDI department has a dedicated team whose primary function is to consult and serve providers regarding Electronic Data Interchange (EDI) use. Our team is experienced in dealing with a variety of provider specialties, billing services, and software vendors.
We continue to offer and improve our superior EDI software products based on our Trading Partners’ needs, as well as our supplemental EDI products, such as Electronic Remittance Advice (ERA), Electronic Funds Transfer (EFT), and real-time eligibility and claim status transactions
WPS Health Insurance has years of experience in EDI transaction processing. We provide EDI services to our Trading Partners for WPS Health Insurance, TRICARE East Region, TRICARE Overseas, TRICARE For Life, Medicare MAC J5 Parts A and B, MAC J8 Parts A and B, WPS Health Plan and Aspirus Arise contracts.
We look forward to working closely with all of our Trading Partners to provide excellent EDI service and support today and into the future. Providers who are interested in becoming an EDI Trading Partner with WPS should contact our EDI team.