Users Manual Winasap 2003 Version 1.0 As of September 15, 2003 · Users Manual CMS Professional As...

U s e r s M a n u a l

W i n a s a p 2 0 0 3

V e r s i o n 1 . 0

A s o f S e p t e m b e r 1 5 , 2 0 0 3

WINASAP 2003 Users Manual

CMS Professional

As of September 2003 1

Table of Contents

Welcome to WINASAP2003..………………………… 2 Loading WINASAP2003..……………………………. 3 Payer Screen..…………………………………………. 10 Trading Partner..……………………………………… 11 Host Phone Number…..………………………………. 13 Provider Reference File.……………………………… 13 Patient Reference File………………………………… 16 Procedure Reference File...…………………………… 18 Diagnosis Reference File……………………………… 19 Create a Claim..……………………………………….. 20 Sending Claims..……………………………………… 24

Receiving a Response file……………………………… 27

Reports………………………………………………… 28

Copy a Claim…………………………………………… 31


CMS Professional


Welcome to WINASAP2003 Billing! Let’s begin! What is WINASAP2003? Windows Accelerated Submission And Processing 2003 What is required to use WINASAP2003? Windows 98 Second Edition, Windows NT, Windows 2000 (Service Pack 3) or Windows XP operating system Pentium processor CD-ROM drive 25 Megabytes of free disk space 128 Megabytes of RAM Monitor resolution of 800 x 600 pixels Hayes compatible 9600 baud asynchronous modem Telephone connectivity Where can I obtain WINASAP2003? There are two options: You can call ACS EDI Gateway at 1-800-672-4959 and request a CD be sent to you, or download it off the ACS EDI Website. www.acs-gcro.com

http://www.acs-gcro.com/


CMS Professional


If you choose to Upload WINASAP2003 from a CD, insert the CD into your CD-ROM. Skip to page 5 of this packet. If you choose to download WINASAP2003 from ASC EDI Gateway. You will click on the “boxed icon”

Click “Save”


CMS Professional


Click “Save” You will then close this program and go to your desktop. You will find a WINASAP2003 Icon. Double click on the WINASAP2003 Icon.

Click “Continue”


CMS Professional


This is a progress screen, please wait.

Click “Next”


CMS Professional


Click “Yes”

You will type you Name. If you are self-employed, you will type your name again. If you work for an organization (example, a Hospital or Facility) type the organizations name. Click “Next”


CMS Professional


Click “Next”

Click “Next”


CMS Professional


This is a progress screen, please wait.

Still processing, please wait.


CMS Professional


Click on the box in front of “Yes, Launch the program file” Then Click “Finish”. Then go to your desktop and Double Click on the “WINASAP2003” Icon.

Leave the User ID as “ADMIN”. Tab to Password and type “asap”. Then Click “OK”


CMS Professional


Click “OK”

Click “File” then Click “Open Payer”


CMS Professional


You must complete the following criteria:

Select Payer: Use the down box to the far right. Go to the bottom and Click “Wyoming Medicaid” Click “OK”

Click “File” then Click “Trading Partner”


CMS Professional



Trading Partner Identification: Primary Identification: You will enter your 5 or 6 digit Trading Partner ID number assigned to you by ACS EDI Gateway. This information is listed on the Logon Sheet sent to you from the EDI Support Unit. Secondary Identification: You will re-enter your 5 or 6 digit Trading Partner ID number assigned to you by ACS EDI Gateway. This information is listed on the Logon Sheet sent to you from the EDI Support Unit. Trading Partner Name: Entity Type: “person”, an example of a “non-person” would be a Hospital or a Nursing Home. You will enter your last name, first name and initial (optional) Contact Information: Contact Name: Enter your Name Telephone Number: Enter your phone number Fax Number: Enter your fax number (optional) Email: Enter your email address (optional)


CMS Professional



WINASAP2003 Communications: Host Telephone Number: This phone number is listed on the Logon Information sheet from ACS EDI Gateway. User Id Number: Enter the User ID # exactly as it appears on your Logon Form. User Name: Enter your User Name exactly as it appears on your Logon Form. Click “Save”


CMS Professional


Congratulations, You are now ready to build your Reference Screens! Step 1. Click “Reference”

Click “Provider”

Click “Add”


CMS Professional



Provider ID #: Enter your 9-digit EqualityCare provider number Provider Name: Entity Type: Enter “Person” or “Non-Person” Enter your Last Name, First Name, Middle Name (optional) or Organization Name Contact Information: Enter a your name, your phone number, fax number and email (optional) Provider Address: Enter your address, city, state and Click “Secondary Identification” at the top of the screen.



CMS Professional


Identification Type: Depending upon whether you are paid using your Social Security Number or Tax Identification Number, choose the appropriate Type. Identification: Enter either you Social Security # or Tax Id # Click “Save”


CMS Professional


Your Provider information has been saved. Next you will click “Cancel” “Reference” “Patient” “Add” and then you are ready to enter the patients information.

You must complete the following criteria: Patient Identification: Enter the 10-digit Patient EqualityCare Id # Enter the patient’s social security number You must create a Patient Account # Patient Name and Demographic Information: Enter the patient’s Last Name, First Name, Middle initial (optional) Enter the patient’s Date of Birth


CMS Professional


Enter the patient’s Sex Patient Address Information: Enter the patient’s address, city, state and zip code Enter the patient’s Telephone # (optional) Next you will click “Insured’s Data” at the top of the screen.


Patient Relationship to Insured: Use the drop down box and choose the appropriate category. We will use “Self” as an example. Entity Type: Use the drop down box and choose the appropriate category. We will use “Person” as an example. Payer Responsibility Sequence Code: Use the drop down box and choose the appropriate category. We will use “Primary” as an example. Click “Save”


CMS Professional


Your Patient information has been saved. Next you will Click “Cancel” “Reference” “Procedure” “Add” and then you are ready to enter the procedure information.


CMS Professional


Completion of this screen is Optional

Procedure Code Data: Procedure Code: Enter your 5-digit procedure code Procedure Code Description: Enter a description of the procedure code Procedure Code: Enter the charge amount per unit Click “Save” If you have additional procedure codes click “Add” and complete the above instructions until all the procedure codes you want to have in the reference file are added.


CMS Professional


Your Procedure code information has been saved. Click “Cancel” “Reference” “Diagnosis Code” “Add” and then you are ready to enter the diagnosis information.


CMS Professional


Completion of this screen is Optional

Diagnosis Code Data: Diagnosis Code: Enter your 3-5-digit diagnosis code Diagnosis Code Description: Enter a description of the diagnosis code Click “Save” If you have additional diagnosis codes Click “Add” and complete the above instructions until all the diagnosis codes you want to have in the reference file are added.


CMS Professional


Your Diagnosis code information has been saved. Click “Cancel”


CMS Professional


Step 2. Lets build a Claim! You are now ready to create your first WINASAP2003 claim. Click “Claims” and then “Professional”

Click “Add”


CMS Professional



Bill Date: Enter today’s date Claim Status: The initial status will be “keyed” Patient Information: Patient Id# (you can use the drop down button and choose the patient id number) the fields will be automatically filled in. Provider Information: Billing Provider ID: Enter your 9-digit Wyoming EqualityCare Provider number (You can use the drop down button and choose the provider number) Pay-to-Provider ID: Again, enter your 9-digit Wyoming EqualityCare Provider number (You can use the drop down button and choose the provider number) Signature on file: Click “Yes” Rendering Provider ID: (If applicable) Enter the 9-digit Treating EqualityCare Provider Number Claim Data: Principal Diagnosis: Enter your 3 to 5-digit diagnosis code (You can use the drop down button and choose the diagnosis code) Other Diagnosis Codes: If you have additional diagnosis codes. Enter your 3 to 5-digit diagnosis code. (You can use the drop down button and choose the diagnosis code)


CMS Professional


Place of Service: Use the drop down button and choose the place of service that is appropriate Claim Frequency Type Code: You can use the drop down button and choose the claim frequency type code that is appropriate Click “Next Page”


CMS Professional



Claim Codes: Medicare Assignment Code: Use the drop down box and enter the appropriate assignment code. Release of Information Code: Enter “Appropriate Release of Information on file at Health Care Service Provider or at Utilization Review Organization” Patient Signature Source Code: Enter “Signed Signature Authorization form or forms for both HCFA 1500 claim Form Block 12 and Block 13 are on file” Claim Filing Indicator Code: Enter “Medicaid”

This is a situational Screen


CMS Professional


Please read over the option and complete the fields that are appropriate to your client. Example, if this is a child being seen for a Well Child Check you need to complete “EPSDT info.” If this client has another insurance, you will need to complete “Other Subscriber Info.” Click “Next Page”


Service Date(s): You have two options for entering the date(s) of service. You can type the date in the above format or Click on the red calendar and choose the date(s). Service Qual: Most providers will use “HCPCS” Procedure Codes: Enter the appropriate procedure code. (You can use the drop down button and choose the procedure code, if you have the code in your reference file.) Procedure Modifiers: Enter the 2-digit modifier only if the procedure code requires a modifier. Unit Code: Use the drop down box and choose the appropriate Unit Code Unit: Enter the total number of units that were provided. Charges: This field will automatically file in the charges, if you have the code and unit charge in your reference file. Otherwise, you will need to calculate the charges and enter the amount.


CMS Professional


Diagnosis Pointer: Enter the number that coincides with the diagnosis listed on screen 1. Place of Service: Use the drop down box and enter the code that appropriately shows where the client was seen. Add Line Item: To add this information Click “Add Line Item”. If you have more lines to add, go back to “Service Date(s) and enter the additional information. Click “Save”

Congratulations! You have just successfully entered your claim. Click “Cancel”


CMS Professional


Step 3. You are now ready to Send your Claims.

Click “Tools” then Click “Send Claim File”


CMS Professional


Click “Select by Claim Type” then Click “Send”

Click “OK”


CMS Professional


The transmission is in process, please wait.

Your claims have been sent successfully. Click “Cancel” Within a few hours your response file will be accessible.


CMS Professional


Remember to a couple of hours after submission before attempting to retrieve your response file. Click “Tools” then “Receive Response File”

Click on “Receive” Once you retrieve your response, you will have verification that your claims were accepted.


CMS Professional


Step 4. You are now ready to retrieve your claims reports. Click “Tools” then Click “Reports”

Click the box in front of the report that you would like to view. Click “Run”

The following are examples of each report.


CMS Professional



CMS Professional


Click “Copy” to make a new claim from a billed claim.

Enter today’s date, Click “Claim Line Items”


CMS Professional


Change the dates, units to match your billing for this month. Click “Add line item” Click “Save”. You can now Send your new claim.

Users Manual Winasap 2003 Version 1.0 As of September 15, 2003 · Users Manual CMS Professional As...

Documents

Transcript of Users Manual Winasap 2003 Version 1.0 As of September 15, 2003 · Users Manual CMS Professional As...