San Francisco Changes Bill Review, e-Bill Resubmissions Required
Starting February 28, 2022, Allied Managed Care replaces EK Health as the bill review vendor for the City and County of San Francisco (CCSF). Accordingly, providers must submit Requests for Authorization (RFAs) and electronic and non-electronic bills to Allied Managed Care, per CCSF’s instructions.
Additionally, daisyBill discovered that CCSF’s clearinghouse vendor, Data Dimensions, incorrectly rejected compliant electronic bills submitted by providers on or after February 2, 2022. Providers must resubmit these incorrectly rejected bills in order for CCSF to process and pay these bills.
daisyBill will resubmit all incorrectly rejected bills on behalf of daisyBill clients; we urge non-daisyBill providers to also resubmit all CCSF e-bills that Data Dimensions improperly rejected.
For their part, CCSF responded quickly and worked admirably with providers to address this unfortunate glitch.
CCSF Switches Bill Review
On February 2, 2022, CCSF sent a memorandum to providers announcing that Allied Managed Care will assume responsibility for all CCSF RFAs and bills, effective February 28, 2022.
The memorandum included the submission instructions below:
CCSF Incorrectly Rejects e-Bills: Doctors Must Resubmit
Clearinghouse vendors accept provider e-bills and return electronic acknowledgments of receipt on behalf of claims administrators that lack the technology to do so. CCSF’s clearinghouse vendor, Data Dimensions (formerly WCEDI), experienced significant complications while preparing for CCSF’s bill review switch.
Data Dimensions erroneously rejected compliant provider e-bills for CCSF, as follows:
- Providers sent CCSF compliant e-bills in the required X12 837 EDI format.
- CCSF sent providers an electronic acknowledgment, known as a 277 ACK, indicating CCSF accepted these e-bill for processing.
- Subsequently, CCSF sent the providers conflicting (and untimely) 277 ACKs indicating these same bills were rejected due to the following reason: “BILL CANNOT BE DELIVERED ELECTRONICALLY”
daisyBill reached out to CCSF and Data Dimensions regarding their EDI error. Both entities confirmed the error and instructed that providers must resubmit the rejected e-bills for processing.
Importantly, failure to resubmit these rejected e-bills means that CCSF will not receive the bills for processing. Again, daisyBill is resubmitting all incorrectly rejected CCSF bills for our clients. Other e-billing providers will need to likewise resubmit their e-bills to CCSF.
Additionally, we would like to commend CCSF for the way they handled this glitch.
As a fierce advocate for better billing and payment, daisyBill recognizes that complications can occur in pursuit of greater efficiency. On behalf of daisyBill and our providers, we appreciate the extraordinary promptness with which CCSF took charge and worked to resolve the problem.
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