MAC Jurisdiction 5 - Part A & Part B

WPS has been the Medicare Administrative Contractor (MAC) for Jurisdiction 5, which includes Parts A/B for the states of Iowa, Kansas, Missouri, and Nebraska, since September 2007.

The WPS production cutoff time is 4 p.m. Central Standard Time. Claims received by 4 p.m. CST will be processed on the same business day.

EDI Set-up with WPS

New Providers that wish to file electronically will have to sign an EDI Enrollment Form with WPS.

All providers, however, that will submit EDI claims directly to WPS will need to complete the self-registration process on our WPS Trading Partner System (WTPS) to prepare for transaction testing and production claim submission. Access the WPS Trading Partner System (WTPS). Providers without Internet access may register for EDI by contacting us at the telephone numbers indicated in Contact EDI.

If your office will submit EDI claims through a clearinghouse or Billing Service, your clearinghouse or Billing Service will need to register on our WTPS application.

After registration has been completed on WTPS, we will send you the appropriate submitter ID and password information to connect to our WPS Bulletin Board System (BBS) through asynchronous telecommunications, along with our BBS user guide. If you use a clearinghouse or Billing Service, we will coordinate this information through your clearinghouse or Billing Service.

Forms for all Transactions (276/277, 835 and 837) can be located under Forms - in the sidebar located to the right.

EDI Testing for MAC J5

Important notice: Effective January 1, 2012 All Medicare covered entities must be fully compliant with 5010. It is suggested that if you are new to Medicare that you begin testing with the 5010 process immediately. Please refer to the 5010 Readiness – New for additional information.

Once your agreement is processed you will receive an EDI submitter number, password and either Bulletin Board System (BBS) instructions or Secure-EDI instructions (PDF) based on the submission method you chose. You are now ready to test. To prepare your test file, please refer to the appropriate WPS HIPAA Companion Document. You will need to submit a test file of at least twenty-five (25) claims that are applicable to your practice (i.e., office visits, x-rays, lab work), so we can ensure your future production claims will process in an efficient manner. These claims can be live, previously paid of created claims as they will not process for payment. Once you have created your test file, you can submit through your chosen submission method. There is no need to notify our office that you are sending a test file.

When your test file has been submitted through either WPS Secure-EDI or the WPS Bulletin Board System (BBS) we will telephone or email your office with the results of your test and either approve the claim files for production, or request that you make any necessary modifications to your data and submit another test file. We will make every effort to contact you with your test results within 2 – 3 business days of your submission.