HIGLAS

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

Date            
Action
June 10, 2020
Release payments for all claims already approved to pay
June 10, 2020
Last MCS payment cycle (payment floors reduced to zero)
June 11, 2020
HIGLAS transition begins
June 12-June 16, 2020
No payments will be issued − ERAs and paper RAs are not produced
June 15, 2020
HIGLAS transition completed – payment floors reinstated
June 17, 2020
Production and distribution of ERAs and paper RAs resume
June 17, 2020
Begin processing backlogged files and issuing payments
June 17-July 1, 2020
Providers may experience a significant reduction in payments due to the early claim payments issued immediately prior to the transition. Providers need to monitor and manage their cash flows during this time period.


Contact Railroad Medicare

Email Railroad Medicare

Contact a specific Railroad Medicare department

Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 

Click to Chat Now