2026 March Network Connection

REQUIREMENTS: By March 13, 2026: Billing team must immediately implement the following changes: 1. STOP creating secondary claims for dual-coverage Medicaid members in Presbyterian system 2. Configure billing software to REQUIRE providers to manually submit both primary AND secondary claims when dual coverage exists 3. Update all claim submission templates and clearinghouse configurations to include: - Presbyterian Payor ID (Segment GS03): 77048 (for PROVIDERConnect or approved clearinghouses) - Loop 2010BB (Segment NM109): NMPHP (for approved clearinghouses) 4. Implement mandatory verification step in billing workflow: Verify member last name and date of birth match the HCA member portal BEFORE claim submission 5. Review and update approved clearinghouse list; ensure only HCA-approved clearinghouses are used for Turquoise Claims submissions Before March 23, 2026: Billing team and providers must: 1. Complete training on Turquoise Claims system through HCA webpage or Presbyterian Provider News page 2. Test claim submissions using new identifiers in staging environment 3. Review potential claim denial codes provided by Presbyterian for Turquoise Claims 4. Update provider-facing documentation and workflows CONSEQUENCES: Claims submitted without correct identifiers or without dual claim submission will be DENIED by Turquoise Claims system. Failure to verify member information will result in claim rejections and payment delays.