Ready or not, here comes Compass21
By Rick Olivas, NHIC

National Heritage Insurance Company unveils new claims processing system

Compass21, the Texas Medicaid Claims Administrator's new claims and encounters processing system, will replace the current claims processing system on Aug. 6, 2001. Compass21, or C21, has been developed by NHIC for the Texas Department of Health. C21 uses the latest in information technology to advance claims and encounter processing methods and improves claims processing efficiency. With C21, the need to have multiple systems for multiple programs is eliminated. All the TDH Texas Medicaid programs offered, like Medicaid, Managed Care, Long Term Care, Children with Special Health Care Needs and Family Planning, can be processed by the Compass21 system.

The new Compass21 system demonstrates the commitment of NHIC and the TDH to continue to improve processes within the Medicaid program and to be dedicated to providing the highest level of service for Texas Medicaid providers and clients.

There are several changes associated with the implantation of Compass21:

• Use of the Texas Provider Identifier instead of the current nine-character provider number

• TDHconnect software upgrade as well as new PC requirements for the upgrade

• Remittance and Status Report improvements

• Standard Vendor-required formats of NSF, UB92, or ANSI

• 24-digit Internal Claim Numbers instead of 15

• Addition of claims processing for Titles V, X, and XX for dates of service Sept. 1, 2001 and later

• New family planning claim for titles V, X, XIX (Medicaid) and XX family planning professional services

• Processing of additional Chronically III and Disabled Children's Program services

• Elimination of current vision claim form (TI9-007).

Texas Provider Identifier

The Texas Provider Identifier replaces the current Medicaid provider number. The new TPI will automatically be assigned to each Medicaid provider and these numbers were mailed out beginning on May 3, 2001. Providers should begin using the assigned TPI on Aug. 6, 2001. Providers are urged to inform their software vendors and billing companies of their new TPI numbers since the TPI will be sent to each provider's physical address, and the provider's address may not be the same as the billing company’s address.

There will be a six-month transition period when claims submitted with old provider numbers will automatically be converted to a provider's new TPI. All processing will be completed with the TPI, and the Remittance and Status Report will have only the TPI on it. After Feb. 6, 2002, claims submitted with the old provider numbers will not be automatically converted, but will be denied.

Electronic claims submission

 TDHconnect version 2.0 software will be provided by NHIC to all current users of TDHconnect—no action is required by the provider to receive their copy of TDHconnect version 2.0. Deployment of TDHconnect software began on May 3, 2001. Version 2.0 is being sent to providers on CD-ROM and includes a Quick Start Guide with loading instructions. Providers who have previously requested the software but have never used it will also automatically receive the new software.

Providers who submit claims electronically to NHIC using a vendor or billing service should inform the service that vendor testing began on March 29, 2001. Vendor specifications have been posted at www.texmednet.com. Specific vendor questions related to Compass21 testing can be answered by calling the EDS Help Desk at 1-888-863-3638. Questions about Compass21 can be answered by calling your NHIC Provider Relations Training Specialist or the Compass21 Provider Hotline at (512) 514-3609.