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Printed Date: 9/22/2015
The Healthcare Integrated General Ledger Accounting System (HIGLAS) is a uniform, integrated, dual-entry accounting system that replaces Medicare’s many accounting systems with a single, unified system that is used by all Medicare claims administration contractors. Once a claim has been processed by the existing Medicare contractor data centers and systems, HIGLAS performs the payment calculation, formatting, and accounting. HIGLAS replaces the accounting processes used by the Medicare contractors; it does not replace the claims processing activities.
All Part B Medicare Administrative Contractors already use HIGLAS. Effective June 15, 2020, the Palmetto GBA Railroad Retirement Board Specialty Medicare Administrative Contractor (RRB SMAC) will be transitioning our financial accounting system from the Multi-Carrier System (MCS) to HIGLAS. Palmetto GBA will be sending a HIGLAS education letter (PDF, 282 KB) to providers soon.
Temporary Waiver of the Claims Processing Payment Floor
CMS has approved Palmetto GBA’s waiver request to reduce the payment floor for both paper and Electronic Data Interchange (EDI) claims. Beginning June 10, 2020, the payment floor will be reduced to zero for both EDI and paper claims, and payments will be released for claims that have already been approved for payment.
This temporary reduction of the payment floor will result in payments being issued early (checks and Electronic Funds Transfers (EFTs)). This may give the appearance that your cash revenues have increased when in fact payments for some of your claims may have simply been made earlier than normal. Providers are encouraged to monitor their payments and make adjustments as necessary to prevent cash flow problems during the transition period.
HIGLAS Payments and Remittance Advices (RAs)
The RRB Specialty MAC will not be issuing payments from June 12 through June 16, 2020. Electronic Remittance Advices (ERAs) and paper RAs will not be available. The RRB Specialty MAC will resume normal payment cycles and issuance of payments on June 17, 2020, at which time providers will be able to retrieve their ERAs.
RRB Specialty MAC HIGLAS Transition Timeline
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Last Updated: 11/01/2020