Cahaba GBA Transitions to Healthcare Integrated General Ledger Accounting System (HIGLAS)
Effective August 7, 2008, Cahaba GBA will be transitioning our Part A financial accounting system from the Fiscal Intermediary Standard System (FISS) to the Healthcare Integrated General Ledger Accounting System (HIGLAS). This transition involves only the financial accounting system. We will continue to use FISS for all claims processing activities.
Implementation of HIGLAS will enable the Centers for Medicare & Medicaid Services (CMS) to track Medicare payments and to accurately pay claims for over 40 million Medicare beneficiaries. The transition will also provide CMS with enhanced oversight of contractors' accounting systems, as well as access to more accurate, timely, and consistent data for decision-making and for performance evaluations.
Introduction to HIGLAS
HIGLAS information is available on the Cahaba GBA website. ‘Ask the Contractor’ sessions are scheduled in August to provide additional information regarding HIGLAS and provide an opportunity for questions.
Announcements of HIGLAS implementation information continues to be provided on our Web site, issued in our listserv messages, and published in our monthly newsletter, the Medicare A Newsline. Individual letters have been mailed to all active providers outlining the changes and impact of HIGLAS to their organization.
Temporary Waiver ofthe Claims Processing Payment Floor
CMS has approved CahabaGBA's waiver request to eliminate the payment floor for the transition and releasepayments early for both electronic and paper claims. All finalized claims willbe released for payment on August 6, 2008.
This temporaryreduction of the payment floor will result in increased cash revenues duringthis time period. However, the payment floor will be reinstated immediatelyafter the transition which will result in claims building on the payment flooruntil the required release date. Please monitor your payments and makeadjustments as necessary to prevent cash flow problems after theimplementation.
Transition Activities
On August 6, 2008, Cahaba GBA will run the last FISS payment cycle and begin the HIGLAS transition. (See Transition Timeline below.)
- Thetemporary waiver of the payment floor rules described above will result inall payments being issued early.
- Providersshould continue to submit claims as normal and make routine correctionsthrough Direct Data Entry (DDE).
- Followingthe transition, Cahaba GBA will resume normal scheduled payments. Thepayment floor will be reinstated at this time.
- Theschedule for payments and Remittance Advice (RAs) will return to normalfollowing the transition to HIGLAS the week of August 11, 2008.
HIGLAS Remittance Advice
Cahaba GBA will not be issuing payments August 7 and August 8, 2008. Electronic Remittance Advice (ERA) and paper RA will not be available on August 8, 2008. Normal payment cycles and issuance of payments will begin the evening of August 11, 2008 for the Regional Home Health Intermediary (RHHI) and the evening of August 13, 2008 for the Fiscal Intermediary (FI) at which time providers will be able to retrieve their ERAs.
Cahaba GBA Transition Timeline for Alabama - FI
| Date | Action |
|---|---|
| August 6, 2008 | Last PIP cycle before transition begins. |
| August 6, 2008 | Release of all processed claims for payment. |
| August 6, 2008 | Last FISS payment cycle (payment floor at 0). |
| August 7, 2008 | HIGLAS transition begins. Payment floor reinstated. |
| August 8, 2008 | No payments generated - No ERA or paper RA issued. |
| August 10, 2008 | HIGLAS transition completed. |
| August 13, 2008 | First payment cycle following HIGLAS transition. |
| August 13 - 21, 2008 | During this time, providers may experience significantly lower payment amounts due to claims being paid earlier than normal. |
| August 15, 2008 | Production and distribution of ERA and paper RA resume. |
| August 20, 2008 | First PIP cycle after transition - PIP cycles resume per normal schedule. |
Cahaba GBA Transition Timeline for Iowa - RHHI
| Date | Action |
|---|---|
| August 4, 2008 | Last PIP cycle before transition begins. |
| August 6, 2008 | Release of all processed claims for payment. |
| August 6, 2008 | Last FISS payment cycle (payment floor at 0). |
| August 7, 2008 | HIGLAS transition begins. Payment floor reinstated. |
| August 7 - 8, 2008 | No payments generated - No ERA or paper RA issued. |
| August 10, 2008 | HIGLAS transition completed. |
| August 11, 2008 | First payment cycle following HIGLAS transition. |
| August 12, 2008 | Production and distribution of ERA and paper RA resume. |
| August 12 - 21, 2008 | During this time, providers may experience significantly lower payment amounts due to claims being paid earlier than normal. |
| August 25, 2008 | First PIP cycle after transition - PIP cycles resume per normal schedule. |
Changes You Will See as a Result of HIGLAS
Provider Address Utilized for Overpayment Demand Letters
Currently, the overpayment demand letters are mailed to a contact previously identified by the provider. Once HIGLAS is implemented, the overpayment demand letters will be mailed to the master physical address of the facility (Address 1 in FISS). This is defined as the “Practice Location Information” in Section 4A on the Provider/Supplier Enrollment application, CMS-855A form.
HIGLAS Impact on Voided/Reissued Checks
Currently, when a check/payment needs to be voided and reissued, it is a manual process completed in FISS. The reissued payment appears on the Refund payment line of the RA. After transition, if a check needs to be voided and subsequently reissued, the transaction will take place in HIGLAS. The reissued amount will be reflected in the Voided/Reissued line on the RA, and any withholding against reissued payments will be included in the Settlement Withholding line of the RA.
In HIGLAS, the voided payment will be included in a future payment, and the reissued payment will be noted on the Voided/Reissued line of the RA. No carbon copy of the original RA will be sent. Additionally, if the provider has outstanding receivables at the time of reissue, the reissued payment may be reduced by any eligible receivables. This will be reflected on the Settlement Withholding line of the RA. Lastly, if the provider has additional claim payments at the time of the reissue, those claim payments will be added to the reissued payment resulting in a different check amount than the original, mutilated check.
Claims and Settlement Payments Subject to Penalty Withholding
Providers are placed on penalty withholding for late cost reports and credit balance reports. Currently, the penalty withholdings are applied to the net payment after any overpayments have been offset. In HIGLAS, the penalty withholding will be applied at the claim level. As a result, the money withheld for a penalty withholding will be reflected as credited to any overpayment until the penalty withholding is released.
HIGLAS Impact on Recoupments from Affiliated Providers
In instances when settlement overpayments are determined, a letter is sent to the provider notifying them of the amount owed to the Medicare Program. If payment is not received within the specified time period, all payments to the provider are recouped until the overpayment is collected. Currently, the recoupment can include any affiliated provider. This is an option of the contractor. Under HIGLAS, the recoupment will be made from affiliated providers. Affiliated providers are all providers that have the same Tax Identification Number (TIN). On the ERA, a code of “OA” is used for Part A Affiliated Withholdings. However, the paper RA does not contain any information to distinguish affiliated withholdings from other withholdings.
Claim Processing Impact
The online system is currently available on Federal holidays that Cahaba GBA has a regularly scheduled business day. Cahaba GBA processes claims on these holidays although no payments are issued. With the implementation of HIGLAS, claims will no longer be processed on Federal holidays. The online system will continue to be available to providers for entering and correcting claims. Any claims entered or corrected by providers on Federal holidays will not be processed until the next claims processing cycle. Payments will not be affected because we do not currently issue checks or EFTs on Federal holidays.
If you have any questions regarding this information, please contact the Provider Contact Center toll free at:
Home Health 1-877-299-4500
Hospice 1-866-539-5592
Part A Providers - Alabama 1-866-539-5598
Part A Providers - All other states 1-877-567-3092
Page last updated: August 5, 2008
