NJ Medicare-Important Update for Part B Providers
Date: 07/17/2008
Source: http://www.highmarkmedicareservices.com/transition/j12/newsroom-index.html If you are an NGS customer in New Jersey currently using Electronic Funds Transfer (EFT) to receive your Medicare payments, please be on the lookout for this important letter advising you of the transition impact to you and what you need to do to respond. Please mark your CMS-588 Form as “Revision to Current Authorization” and print MAC at the end of that line on the CMS-588 Form to assist in processing. Remember to list Highmark Medicare Services as the contractor in Section V on page 2.Dear Provider: Welcome to Highmark Medicare Services, the Jurisdiction 12 (J12) Medicare Administrative Contractor (MAC). Our goal is to ensure a smooth transition of your services from your current contractor to Highmark Medicare Services. As part of transition, we are required to obtain a new CMS-588 EFT Agreement (Electronic Funds Transfer Authorization Agreement) from each provider/supplier who is currently receiving Medicare payments electronically before we may make payment to you via electronic funds transfer. Failure to complete and submit a CMS-588 Form will result in a delay or interruption of your Medicare payments at and after transition. In order to avoid delays in your Medicare payments, please complete the enclosed CMS-588 form and return it by August 30th, 2008 to: Highmark Medicare Services
Provider Enrollment
1800 Center Street
PO Box 890157
Camp Hill, PA 17089-0157
Please read the following tips for correct completion of the form. The PTAN noted at the top of this letter is the Provider Transaction Access Number, formerly known as your Medicare Number or Provider Identification Number (PIN). Part II of the CMS-588 form requires the PTAN to be reported as the “Medicare Identification Number.” An individual healthcare practitioner must personally sign the form. For groups and organizations, the form must be signed by an authorized or delegated official on file with Medicare. Please remember to list Highmark Medicare Services as the contractor on page 2 in Section V and be sure the form is signed and dated. You will receive acknowledgement of your application when it is processed. NOTE: You are not required to complete a CMS-855 Enrollment form as part of this process. If you have any questions about the completion of the CMS-588 form, contact the Provider Enrollment Helpline at 1-866-488-0549. In addition, further details can be found on our J12 Transition webpage at: http://www.highmarkmedicareservices.com/transition/j12/index.html Thank you for your cooperation. We look forward to serving you. Sincerely, Judy Andidora, Manager
Provider Enrollment Services
Provider Action:
No action required by provider.
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