Maintenance of Contractor Workload Identifiers

50 - Maintenance of Contractor Workload Identifiers (Rev. 47, 06-25-04) There are several major circumstances that may require changes or updates to the contractor workload identifiers. Maintenance of the identifiers, including the contractor number and the BSI, will be the responsibility of the Center for Medicare Management, which will notify the affected claims processing contractor of any changes. • Contractor Transitions - The new or incoming contractor will be instructed by the CMS transition manager about any changes in the contractor workload identifier, both the contractor number and the BSI. • Provider Change of Intermediary - The BSI of a Part A provider (e.g., hospital, skilled nursing facility, home health agency, etc) may change when CMS approves a provider’s request for change of intermediary or the provider’s request to submit all bills to a single intermediary because of a chain relationship. CMS will advise the new intermediary, as well as the former intermediary, of the required change in the BSI through the tie-in notices which are necessary to coordinate the change of intermediary process. • Generally, the BSI of carriers and DMERCs will not change, but CMS will advise of any changes during any contractor transition. New Systems Implementations - As contractors are implemented on HIGLAS and REMAS, transactions that are converted into the HIGLAS and REMAS databases shall be converted with their appropriate BSI(s) to distinguish different workloads. CMS will advise for any HIGLAS implementation. Exhibit 1 (Rev. 47, 06-25-04) Contractor Workload Identifiers __________________________________________________________________ State Contract Contractor Workload Identifier Type CROWD Business Identifier Segment Multiple FI Mutual of Omaha 52280 NTA_ Multiple Carrier Railroad Retirement Board 00882 RRB_ (Palmetto) Alabama FI Cahaba 00010 ALA_ Carrier Cahaba 00510 ALB_ RHHI Palmetto 00380 ALR_ DMERC Palmetto 00885 RCD_ Alaska FI Noridian 00322 AKA_ Carrier Noridian 00831 AKB_ RHHI UGS 00454 AKR_ DMERC CIGNA 05655 RDD_ Arizona FI BCBS Arizona 00030 AZA_ Carrier Noridian 00832 AZB_ RHHI UGS 00454 AZR_ DMERC CIGNA 05655 RDD_ Arkansas FI BCBS Arkansas 00020 ARA_ Carrier BCBS Arkansas 00520 ARB_ RHHI Palmetto 00380 ARR_ DMERC Palmetto 00885 RCD_ California FI UGS 00454 CAA_ Carrier NHIC- Northern CA 31140 CAB_ Carrier NHIC- Southern CA 31146 CAB_ RHHI UGS 00454 CAR_ DMERC CIGNA 05655 RDD_ Colorado FI TrailBlazer 00400 COA_ Carrier Noridian 00824 COB_ RHHI Cahaba 00011 COR_ DMERC Palmetto 00885 RCD_ Connecticut FI Empire 00308 CTA_ Carrier First Coast 00591 CTB_ RHHI AHS Maine 00180 CTR_ DMERC HealthNow 00811 RAD_ Delaware FI Empire 00308 DEA_ Carrier TrailBlazer 00902 DEB_ RHHI Cahaba 00011 DER_ DMERC HealthNow 00811 RAD_ District of FI Carefirst of MD 00190 DCA_ Columbia Carrier* TrailBlazer 00903 DCB_ *Includes parts of MD and VA RHHI Cahaba 00011 DCR_ DMERC AdminaStar 00635 RBD_ Florida FI First Coast 00090 FLA_ Carrier First Coast 00590 FLB_ RHHI Palmetto 00380 FLR_ DMERC Palmetto 00885 RCD_ Georgia FI BCBS Georgia 00101 GAA_ Carrier Cahaba 00511 GAB_ RHHI Palmetto 00380 GAR_ DMERC Palmetto 00885 RCD_ Hawaii * FI UGS 00454 HIA_ Carrier Noridian 00833 HIB_ RHHI UGS 00454 HIR_ DMERC CIGNA 05655 RDD_ * Includes Guam and American Samoa Idaho FI Regence 00350 IDA_ Carrier CIGNA 05130 IDB_ RHHI UGS 00454 IDR_ DMERC CIGNA` 05655 RDD_ Illinois FI AdminaStar 00131 ILA_ Carrier Wisconsin Physicians Svc 00952 ILB_ RHHI Palmetto 00380 ILR_ DMERC AdminaStar 00635 RBD_ Indiana FI AdminaStar 00130 INA_ Carrier AdminaStar 00630 INB_ RHHI Palmetto 00380 INR_ DMERC AdminaStar 00635 RBD_ Iowa FI Cahaba 00011 IAA_ Carrier Noridian 00826 IAB_ RHHI Cahaba 00011 IAR_ DMERC CIGNA 05655 RDD_ Kansas FI BCBS Kansas 00150 KSA_ Carrier BCBS Kansas 00650 KSB_ RHHI Cahaba 00011 KSR_ DMERC CIGNA 05655 RDD_ Kentucky FI AdminaStar 00160 KYA_ Carrier AdminaStar 00660 KYB_ RHHI Palmetto 00380 KYR_ DMERC Palmetto 00885 RCD_ Louisiana FI Trispan 00230 LAA_ Carrier BCBS Arkansas 00528 LAB_ RHHI Palmetto 00380 LAR_ DMERC Palmetto 00885 RCD_ Maine FI Associated Hospital of ME 00180 MEA_ Carrier NHIC 31142 MEB_ RHHI Associated Hospital of ME 00180 MER_ DMERC HealthNow 00811 RAD_ Maryland FI Carefirst of Maryland 00190 MDA_ Carrier* TrailBlazer 00901 MDB_ RHHI Cahaba 00011 MDR_ DMERC AdminaStar 00635 RBD_ * See also District of Columbia Massachusetts FI Associated Hospital of ME 00181 MAA_ Carrier NHIC 31143 MAB_ RHHI Associated Hospital of ME 00180 MAR_ DMERC HealthNow 00811 RAD_ Michigan FI UGS 00452 MIA_ Carrier Wisconsin Physicians Svc 00953 MIB_ RHHI UGS 00450 MIR_ DMERC AdminaStar 00635 RBD_ Minnesota FI Noridian 00320 MNA_ Carrier Wisconsin Physician Svc 00954 MNB_ RHHI UGS 00450 MNR_ DMERC AdminaStar 00635 RBD_ Mississippi FI Trispan 00230 MSA_ Carrier Cahaba 00512 MSB_ RHHI Palmetto 00380 MSR_ DMERC Palmetto 00885 RCD_ Missouri FI Trispan 00230 MOA_ Carrier Arkansas BCBS – East MO 00523 MOB_ Carrier BCBS Kansas - West MO 00651 MOB_ RHHI Cahaba 00011 MOR_ DMERC CIGNA 05655 RDD_ Montana FI BCBS Montana 00250 MTA_ Carrier BCBS Montana 00751 MTB_ RHHI Cahaba 00011 MTR_ DMERC CIGNA 05655 RDD_ Nebraska FI BCBS Nebraska 00260 NEA_ Carrier BCBS Kansas 00655 NEB_ RHHI Cahaba 00011 NER_ DMERC CIGNA 05655 RDD_ Nevada FI UGS 00454 NVA_ Carrier Noridian 00834 NVB_ RHHI UGS 00454 NVR_ DMERC CIGNA 05655 RDD_ New FI BCBS NH/VT 00270 NHA_ Hampshire Carrier NHIC 31144 NHB_ RHHI Associated Hospital Svc 00180 NHR_ DMERC HealthNow 00811 RAD_ New FI Riverbend 00390 NJA_ Jersey Carrier Empire 00805 NJB_ RHHI UGS 00450 NJR_ DMERC HealthNow 00811 RAD_ New Mexico FI TrailBlazer 00400 NMA_ Carrier Arkansas BCBS 00521 NMB_ RHHI Palmetto 00380 NMR_ DMERC Palmetto 00885 RCD_ New York FI Empire 00308 NYA_ Carrier Empire 00803 NYB_ Carrier Group Health Inc. 14330 NYB_ Carrier HealthNow 00801 NYB_ RHHI UGS 00450 NYR_ DMERC HealthNow 00811 RAD_ North FI Palmetto 00382 NCA_ Carolina Carrier CIGNA 05535 NCB_ RHHI Palmetto 00380 NCR_ DMERC Palmetto 00885 RCD_ North Dakota FI Noridian 00320 NDA_ Carrier Noridian 00820 NDB_ RHHI Cahaba 00011 NDR_ DMERC CIGNA 05655 RDD_ Ohio FI AdminaStar 00332 OHA_ Carrier Palmetto 00883 OHB_ RHHI Palmetto 00380 OHR_ DMERC AdminaStar 00635 RBD_ Oklahoma FI BCBS Oklahoma 00340 OKA_ Carrier Arkansas BCBS 00522 OKB_ RHHI Palmetto 00380` OKR_ DMERC Palmetto 00885 RCD_ Oregon FI Regence 00350 ORA_ Carrier Noridian 00835 ORB_ RHHI UGS 00454 ORR_ DMERC CIGNA 05655 RDD_ Pennsyl- FI Veritus 00363 PAA_ vannia Carrier Highmark 00865 PAB_ RHHI Cahaba 00011 PAR_ DMERC HealthNow ` 00811 RAD_ Puerto FI* Cooperativa 57400 PRA_ Rico Carrier(PR) Triple-S 00973 PRB_ Carrier(VI) Triple-S 00974 VIB_ RHHI* UGS 00450 PRR_ DMERC* Palmetto 00885 RCD_ *Includes Virgin Islands Rhode FI Arkansas BCBS 00021 RIA_ Island Carrier Arkansas BCBS 00524 RIB_ RHHI Associated Hospital of ME 00180 RIR_ DMERC HealthNow 00811 RAD_ South FI Palmetto 00380 SCA_ Carolina Carrier Palmetto 00880 SCB_ RHHI Palmetto 00380 SCR_ DMERC Palmetto 00885 RCD_ South FI Cahaba 00011 SDA_ Dakota Carrier Noridian 00889 SDB_ RHHI Cahaba 00011 SDR_ DMERC CIGNA 05655 RDD_ Tennessee FI Riverbend 00390 TNA_ Carrier CIGNA 05440 TNB_ RHHI Palmetto 00380 TNR_ DMERC Palmetto 00885 RCD_ Texas FI TrailBlazer 00400 TXA_ Carrier TrailBlazer 00900 TXB_ RHHI Palmetto 00380 TXR_ DMERC Palmetto 00885 RCD_ Utah FI Regence 00350 UTA_ Carrier Regence 00910 UTB_ RHHI Cahaba 00011 UTR_ DMERC CIGNA 05655 RDD_ Vermont FI BCBS NH/VT 00270 VTA_ Carrier NHIC 31145 VTB_ RHHI Associated Hospital of ME 00180 VTR_ DMERC HealthNow 00811 RAD_ Virginia FI UGS 00453 VAA_ Carrier* TrailBlazer 00904 VAB_ RHHI Cahaba 00011 VAR_ DMERC AdminaStar 00635 RBD_ * See also District of Columbia Washington FI Noridian 00322 WAA_ Carrier Noridian 00836 WAB_ RHHI UGS 00454 WAR_ DMERC CIGNA 05655 RDD_ West FI UGS 00453 WVA_ Virginia Carrier Palmetto 00884 WVB_ RHHI Cahaba 00011 WVR_ DMERC AdminaStar 00635 RBD_ Wisconsin FI UGS 00450 WIA_ Carrier WPS 00951 WIB_ RHHI UGS 00450 WIR_ DMERC AdminaStar 00635 RBD_ Wyoming FI BCBS Wyoming 00460 WYA_ Carrier Noridian 00825 WYB_ RHHI Cahaba 00011 WYR_ DMERC CIGNA 05655 RDD_