J8 WPS: Indiana Medicare

Wisconsin Physician Services (WPS) administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdiction 8, which includes Indiana.  If you are a provider located in Jurisdiction 8 and need to become an electronic submitter for your Medicare A/B claims, please follow the enrollment instructions listed below.

 

WPS recently implemented their new WPS EDI Express Enrollment Self-Service tool for Trading Partner enrollment and management. This will allow you to create your own account, register your line of business and transactions, and retrieve and submit agreements. 

 

EDI Enrollment (Claims/Remits)

Please click the following link to begin registration: https://edi.wpsic.com/edir/home

  • Click "Enroll Now" under Providers if you are a healthcare provider

    • If you are a Billing Service please give us a call at 602-439-2525 for assistance registering 

  • Select 5010 837 Institutional Claim Inbound if you are going to be sending Institutional Claims (UB-04)

  • Select 5010 837 Professional Claim Inbound if you are going to be sending Professional Claims (CMS 1500)

  • On the next screen, please select "I Don't use a clearinghouse/billing agency"

  • Click "Register Now" to begin registration for a WPS Community Manager account

  • On the following screen, under "Step 1", you must click the link that says "Click here to register with WPS community manager"

  • In the new tab that opens, please click "Start Registering"

  • Next, please enter your company name with no unnecessary symbols (exclude commas and periods)

  • Please enter your email address

  • Enter the Captcha displayed for security purposes then click "Next"

  • On the following screen please enter your company address, phone, fax and email

  • Do not enter anything for web URL

  • Please enter the primary legal and support contact information then press "Next" to continue

  • For the "Document Types to Exchange" please only check off "X12" then press "Finish Registration"

  • Review the Registration Summary for accuracy then click "Confirm and Submit"

  • You should receive an email confirming they have received your request and it is pending approval

    • Within 3 business days, you will get another email from CommunityManager@wpsic.com that gives you a link to set your password for Community Manager

    • Please click the link and set your password with the following requirements:

      • ​Exactly 9 characters long with at least one upper case, lower case, a number and a symbol

      • Please keep this information as it will need to be given to your ClaimShuttle representative after you finish registration

      • If you do not get the subsequent email, please call ClaimShuttle for assistance setting your Community Manager Password

  • You can now go back to EDI Express enrollment to finish registration

  • Return to the first tab, press "Continue" and enter your email address in Step 2 then press "Validate"

    • ​If you closed that tab or it timed out, please repeat the steps above until you get to the "WPS Community Manager" screen and instead of selecting "Register Now", enter your WCM Username/Email and the Password you created then press "Login"

  • If necessary, re-enter the email and press "Continue Enrollment"

  • Please enter your Tax ID, Company Name (make sure it matches what you entered when registering for Community Manager), Address, and Contact Info

  • On the following screen, please click "Sign & Submit" to submit the Connectivity Agreement

  • Electronically sign the agreement by entering your name and pressing "Sign Agreement"

  • On the following screen press the button to "Auto Assign a Direct Submitter Trading Partner ID"

    • ​It will now display your Trading Partner ID. Please write this down to give to your ClaimShuttle representative during setup/testing

  • Next, check the box for your Jurisdiction/Line of business

  • Please press Continue on the Mock Agreements screen

  • Please re-enter your Tax ID and Group/Billing NPI

    • ​No need to enter rendering NPI's, only the Group/Billing is required

  • Please enter Contact, Business, and Mailing information then press "Next"

  • On the EDI Registration Summary page, if you want to also sign up for Electronic Remittance Advice (ERA's), click "Add Transaction"

    • Select 5010 835 Remit Outbound

    • Re-enter your company's Tax ID and Billing/Group NPI

    • Enter today's date for the effective date then press "Next"

    • Click "Use This Data"

  • Check the box to Agree, then Sign, and e-sign the agreement

  • If you have added multiple transactions you will need to repeat this step

  • Once done check the boxe(s) next to "I Agree" then press "Done>> Sign Select Agreements"

  • Click "Complete and Submit" on the right to submit your entire application

  • Please click "No Thanks, I'm Done" once your submission is complete

 

 

Testing


Once you have completed the enrollment steps outlined above and have your Submitter ID, Community Manager Login ID, and Community Manager Password, please call ClaimShuttle at 602-439-2525 to complete the mailbox setup and test submission. Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.

 

Once testing is complete, the "Line of Business/Transaction Production Approval Form" must be completed in order to obtain production approval. We will assist you with completing and submitting this form once the test batch has been submitted.

 

You will receive an email within 3-5 business days stating whether production approval has been granted or denied. Once you have been granted production approval you will need to contact your ClaimShuttle Support Representative so they can finish the setup and assist with your first production batch.