TrailBlazer Letterhead

							                                                                                                         MEDICARE
                                                                                                      Part A Intermediary
                                                                                                            Part B Carrier


January 23, 2008

ADDRESS BLOCK

Dear Submitter:

On August 2, 2007, the Centers for Medicare & Medicaid Services (CMS) announced that
TrailBlazer Health Enterprises, LLC (TrailBlazer) was awarded the contract for the combined
administration of Part A and Part B Medicare fee-for-service claims in Jurisdiction 4 (J4). The
states included in J4 are Colorado, New Mexico, Oklahoma and Texas. As the J4 A/B MAC,
TrailBlazer began implementation activities in early September 2007 and will assume full
responsibility for the jurisdiction workload no later than Spring 2008.

TrailBlazer is looking forward to building a successful partnership with all electronic submitters,
and is committed to working with all submitters and vendors toward a smooth implementation as
we assume this important role. The purpose of this letter is to provide the Submitter ID and
password for connecting to the TrailBlazer front-end, GPNet, explain the impact this MAC
implementation will have on EDI transactions, and provide instructions on the changes that must
be made prior to and after the system cutover date of March 1, 2008.

We respectfully request all submitters to please take time to read this information carefully. Our
goal is to make the transition of your EDI billing processes as simple as possible, with minimal
or no disruption.

GPNet Migration

To facilitate the implementation of all J4 A/B MAC submitters, TrailBlazer will migrate all
electronic claim submitters from their current front-end system to our EDI gateway, GPNet. We
encourage submitters to begin migrating to GPNet as soon as possible, utilizing the GPNet
Submitter ID and password supplied below.

All electronic claim submissions submitted to TrailBlazer prior to the final J4 MAC
implementation date will continue to be processed by Pinnacle. Submitters will continue to
obtain Batch Control Listings (BCL’s)/pre pass edit listings and electronic remittance notices
from the Pinnacle front-end until the implementation date.

Complete details and specifications about GPNet can be found in the Communications Manual
on the EDI Web page at: http://www.trailblazerhealth.com/J4/EDI/default.aspx?DomainID=4.
Asynchronous submitters: The GPNet transmission number is (XXX) XXX-XXXX.
File Transfer Protocol (FTP) submitters:
    • The GPNet transmission number is (XXX) XXX-XXXX.
    • Login id: pgbaops
    • Password: opspwd1
    • IP address: 192.168.10.50 2021




                       TrailBlazer Health Enterprises, LLCSM
                           Executive Center III • 8330 LBJ Freeway • Dallas, TX 75243-1213
                              A CMS Contracted Intermediary and Carrier                      C E R T I F I E D
1/25/2008
Page 2 of 3




TrailBlazer provides a detailed GPNet Edits Manual that is available for viewing, printing or e-
mail distribution on the TrailBlazer EDI Web page. Processing changes occur frequently;
therefore, when a new edit is added or an old edit updated, the changes will be published
through a listserv message and posted on the EDI Web page. We encourage submitters to
review this page frequently to ensure they are current on the posted edits.

GPNet Updates

The GPNet Communications Manual and the GPNet Edits Manual are always subject to future
updates/changes. To ensure you receive timely updates, please register for the TrailBlazer J4
MAC listservs by selecting “Register” on the J4 MAC Implementation Home Page at
http://www.trailblazerhealth.com/J4/Default.aspx and fill in the blanks with the required
information. To access and register for listservs, click “LISTSERV” at the top of any J4 Web
page. Providers are encouraged to subscribe to the J4 MAC Implementation News listserv as
well as their state-specific listserv. Select the listserv link you are interested in and then select
“subscribe.” EDI further encourages submitters to register on the TrailBlazer Home Page at
http://www.trailblazerhealth.com/ and register for the EDIPARTB listserv. You will receive a
confirmation e-mail, and confirmation must be made before the subscription is activated.

TrailBlazer offers providers access to an online learning center, known as Centra, which is a
live, interactive, virtual learning educational initiative. TrailBlazer is offering a J4 EDI Resources
Web-based training session on January 31, 2008, to assist providers with the impact this MAC
implementation will have on EDI transactions and provide instructions on the changes.
Submitters/Providers are encouraged to register for this training by accessing the “Calendar of
Events” on the J4 MAC Web site.

Submitter ID Information

As stated in our November 26, 2007, Web posting, TrailBlazer secured a listing of Submitter IDs
from Pinnacle. The Submitter ID insert company name utilized for Pinnacle claim submissions is
not currently being utilized on the TrailBlazer front-end, GPNet. Therefore, the following
Submitter ID and password have been established for claim submission on GPNet by insert
company name.

Submitter ID: insert id
Password: insert password

Implementation Date Changes

TrailBlazer has posted a job aid titled “J4 EDI Changes” that lists the minor changes that will be
necessary for providers to make to their incoming electronic claims, effective with the J4 MAC
implementation date. These changes include the contractor ID and the interchange qualifier.
This document can be found on the J4 TrailBlazer Web site under EDI. For further information,
please reference the TrailBlazer EDI companion guides on the Web site.

Submitters are encouraged to submit test claims to GPNet utilizing the claim format changes
that will be required at implementation.
1/25/2008
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EDI Questions and Assistance

The TrailBlazer EDI Technology Support Center (TSC) may be contacted at (866) 749-4302 for
assistance with connectivity to GPNet and the GPNet response report. The TSC is available
each business day from 8 a.m. – 6 p.m. ET. Submitters are advised to contact their current EDI
support center for questions related to the BCL’s and/or electronic remittance notices.

TrailBlazer looks forward to the opportunity to serve you.

Sincerely,

TrailBlazer EDI Technology Support Center Team