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Screen Descriptions

Screen Descriptions


Send Claims

Professional Claims Sends Professional (aka CMS 1500) claims

Institutional Claims Sends Institutional (aka UB04) claims

Filters Allows you to filter claim, available filters are Chart Number, Claims Number, Claim Number, Claim Billing Code, Claim Date Created, Batch Number

Specifying Batch Number will cause the program to ignore the Claim Status for matching claims.

Do not send file allows a preview of the raw 837 data file without sending the claim

Utilities other functions for manipulating claim data

Open Previous Verification Report allows the user to open an EMC Verificatin Report that has been saved from the preview screen. Also opens the last EMC Verification Report.

Send NPI Only Claims causes the program to ignore legacy numbers in Medisoft, except for LU location numbers

Claim Sequence Select from Primary or Secondary EMCs

Primary Payment Info Allows the user to enter in COB information from the primary EOB that is needed to file secondary EMCs

Online notices and helpful information internet link to documents section of www.megaeasy.net


Reports

Download Reports

View Previous Reports

Print All Unprinted or Only Selected, All Unprinted does not print XML versions of 997 ACKs

Process All Unprocessed RSPs or Only Selected RSP, processes the report for claim status. Only available for CareVu.

View

All Files view all files in report data table

Response Reports

997 ACKs view only 997 ACK xml files

837 Claims view only 837 claim files

Unprinted Responses

Unprocessed Responses

Refresh

Settings

Font

Horizontal/Vertical

Add/Remove

Add Files

Copy File To...

Delete delete the table reference in 1st question, deletes the file off the server in the 2nd question.

Tools

Mark

Mark All Processed mark all listed files as processed

Marks All Printed mark all listed files as printed

ANSI

Normalize ANSI File adds new line character to each segment

Conversion

Update Stylesheets updates the specified XML Stylesheet

835, 997

Fixes

Fix Broken Links scan current file list for records that point to files that don't exist and delete the link

Fix File Extensions attempts to fill in blank EXT field

Strip CRLF removes new line characters

Convert Legacy DB convert legacy report db to current db

Pack and Index

Add Segment Positions adds segment positions to 837 claim files to help resolve 997 ACK rejections

Copy to Clipboard and Open Wordpad copy current document to the clipboard and start wordpad. Once Wordpad is started you can Ctrl-V to paste the report. This can be used to search the document for specific data. Wordpad moves to the data when it is found, InterfaceEDI does not.

 

 

835 Remittance

Print

View

All 835s

Unapplied 835s

Unprocessed 835s

Unprinted 835s

Refresh

Horizontal/Vertical

ERA Setup settings used when using the AutoApply function of InterfaceEDI

You must enter a Payment, an Adjustment, a Withhold, a Deductible and a Take Back Code. Not all the codes are used but they are here for possible future use.

Payment Code

Adjustment Code

WithHold Code

Deductible Code

Take Back Code

General AR Account

Adjust Claim Sequence... from time to time a payer may process a claim as the primary payer when they are set up as the Secondary Payer in Medisoft. This tells the program to look at the payer numbers in Medisoft to determine which pay sequence to use.

Use Adjudication date as... this makes the program use the date of the eob when entering the Date From in payments and adjustments. Also the date is used in Deposit Entry as the Deposit Date. Date Created for Deposits and Transactions are still the system date.


Adjustments on an 835 have two components. The first component is the Group, CO, PR, PI, and OA.

The second part is the Reason Code. An example of this and the most common is CO-45, the adjustment for the Allowed Amount. PR-1 is a Deductible. PR-2 is the patient/coinsurance amount.

With the following fields you can specify which codes to apply from each of those Groups.


Contractual Obligation Adjustments (CO)

Patient Responsible Adjustments (PR)

Payer Initiated Adjustments (PI)

Other Adjustments (OA)

Tools most of the options here are duplicates from other areas of the program

Update ERA Support Data updates 835 support data from the program directory. The ERA support data can be updated by downloading the latest install.

Maintenance packs and rebuilds index on report data table

Working Directory link to folder where files are temporarily stored when sending or downloading

Backup EMC Data Creates a zip file of EMC Reports and PGP keys. These files are not backup with Medisoft


Setup

Claim Options, settings that apply to 837 claim files, including Institutional and Ambulance claim settings

  Ignore transactin attending provider... tells the program to not send the transaction provider if it differs from the Claim provider.

  Send Referring Provider as Ordering Provider... tells the program to create an odering provider for each transaction by copying the referring provider.

  Use EDI Receiver Group Practice... tells the program to look at the Group Practice check box in the Claim EDI Receiver to determine if the claim should be sent as a group claim.

  Send on Chart Number as primary... tells the program to not append the claim number to the primary claim identifier. This may be useful when a non-interfaceedi autopost program is being used.

  Send the attending provider name and address... tells the program to not send the practice information when the claim is a group claim. The provider name and address is substituted in this situation. The     First and Last Name of the provider is combined to make the practice name. This is useful when the Medisoft data set contains two or more group practices that require different names be submitted.

Clear Modem clears saved modem selection when the user uses dialup BBS

Process Rejects after printing... tells the program to process the response report for claim status. If claim is rejected the claim primary status is marked rejected and any message is stored in the comments section of the claims. If a claim is accepted the Date and Report Name is stored in the comments section for future reference.

Verification Report Style controls how the EMC Verification report looks. Summary will give the user 1 line per claim with minimal information.

ERA Export Directory specify a directory here to make the program copy any imported 835 file. Can be useful if the user is using Medicare's Easy Print software.

Claims Export Directory specify a directory here to make the program make a copy of any transmitted 837. Can be useful if the user must submit a copy of the claim file to a third party for reporting purposes.


Connection Type

Connection Type choose how you want to connect

PGP Setup use to set up GNUPG when using FTP with PGP. It is recommended that you use SSH when possible. SSH is the most portable and easy to maintain.

FTP Settings

Use Active Mode FTP the default setting for FTP is to use Passive Mode. This works for most firewall/proxy settings. Turning the Active Mode will sometimes solve problems when the module logs in but will not get a directory listing.

Setup FTP attempts to set up the ftp COM Object. Copies the wodFTPDLX.dll to the windows system32 directory and registers the component. This requires administrative rights.


Registration

Professional Claims enter the registration information manually

Institutional Claims enter the registration information manually

ERA(835) enter the registration information manually

Get Registration attempt to get the registration information over the internet by serial number

Register over the internet send registration information over the internet, requires serial number and authorization code

Updates/Support

Update from the Internet check the web for updates to the program

Support/Enter your six digit pin when using http://www.logmein123.com/ for support

Updates

Check for updates when... makes the program check for updates when it starts

Use MS Proxy Settings... some networks use a proxy to connect to the internet

Use Port 80... the default port for downloads is 8080, this changes it to port 80

Force Update makes the program download an update regardless of the version

Click here to download... downloads a copy of the EDI23.exe from http://www.megaeasy.net/. This is not the same as updating from the internet. The install is usually behind the latest update.