Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the...

62
Welcome PC-ACE Pro32 Training 2008

Transcript of Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the...

Page 1: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

Welcome PC-ACE Pro32

Training

2008

Page 2: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

2

What is PC-ACE Pro32?

●Free software (when downloaded from the internet)

●IME and EDISS supported

●HIPAA compliant

Page 3: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

3

Why use PC-Ace?

●Faster claims processing

●No IME keying errors

●No scanning issues

●User friendly

●It’s free when downloaded from the internet

Page 4: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

4

How to get PC-ACEAccess paperwork at

●www.edissweb.com/cgp/forms/enrollment.html

Download and fill out forms

●Noridian Administrative Services, LLC (NAS) EDI Enrollment Form

●837P Professional Claim, or 837I Institutional Claim, or 837D Dental Claim

●Software Licensing Agreement (SLA)

Forms must be signed by the provider.

Fax enrollment forms to 877-269-1472.

Page 5: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

5

How to get PC-ACE

Download the software at

●www.edissweb.com/cgp/vendors/pcace.html

Access installation and billing instructions at

● www.ime.state.ia.us/providers/forms.html#paphd

Page 6: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

6

The Role of EDISS

●EDISS (Electronic Data Interchange Support Services) is the vendor for IME

●EDISS processes electronic billing applications, sets up accounts with user names and passwords

●EDISS troubleshoots the software

Page 7: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

7

The Role of IME

●Outreach staff at IME can train providers on the software, help providers build files and give instructions on how to install and bill

●Outreach staff can train providers either face-to-face or through a phone call

Page 8: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

8

EDISS Contact Information

Monday, Tuesday, Thursday, Friday

8-5 CST

Wednesday

10-5 CST

www.edissweb.com

[email protected]

Page 9: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

9

Sign up to receive the latest EDISS news

Sign up by going to:

http://mail.noridian.com/wws/subrequest/hipaasubmitter/

Page 10: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

10

Once PC-ACE Pro32 is installed, the icon on the desktop will look like the one below. Double-click on the icon to open.

Page 11: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

11

PC-ACE Pro32 Toolbar

This is the program’s main toolbar

Page 12: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

12

Reference File MaintenanceThis is where the provider and patient files will be built.

Page 13: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

13

You will be asked to enter a User ID and Password when opening the Reference File Maintenance Screen. Enter ‘sysadmin’ for both.

Page 14: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

14

Setting Up Your Provider Files

Page 15: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

15

From the Reference File Maintenance Screen, Click on ‘Codes/Misc’

Page 16: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

16

On the Codes/Misc tab, click on ‘Submitter’

Page 17: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

17

Setting up Professional Provider Files

Page 18: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

18

Click ‘Professional Option’

Page 19: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

19

Click ‘View/Update’

Page 20: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

20

On the Professional Submitted Information screen, complete the required information then click ‘save’.

Page 21: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

21

From the Reference File Maintenance Screen, click on Provider (Prof). Then click ‘new’.

Page 22: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

22

On the New Provider Options screen, choose the appropriate option.

Page 23: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

23

On the Professional Provider Information screen, click the appropriate option.

Page 24: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

24

On the Professional Provider Information screen, complete the required fields, then click on the ‘Extended Info’ tab.

Page 25: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

25

Professional Provider Information (extended info)

Enter ‘XX’ for provider ID/No Type.

Page 26: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

26

Professional Provider Information (Local Fields)Enter Submitter ID given to you by EDISS, then click ‘save’.

Page 27: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

27

Setting up Institutional Provider Files

Page 28: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

28

From the Reference File Maintenance Screen, Click on ‘Codes/Misc’ and then on ‘Submitter’.

Page 29: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

29

Click the ‘Institutional’ Option and then click ‘View/Update’.

Page 30: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

30

On the Institutional Submitter Information screen, complete the required information, then click ‘save’.

Page 31: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

31

From the Reference File Maintenance Screen, click on the Provider (Inst) tab then click ‘New’.

Page 32: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

32

On the New Provider Options screen, select the appropriate choice and click ‘OK’.

Page 33: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

33

From the Institutional Provider Information screen, complete the required information under General Info.

Page 34: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

34

On the Extended Info tab, enter ‘XX’ in the Provider ID/No Type field.

Page 35: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

35

From the Local Fields tab, enter the Submitter ID number sent by EDISS, then click ‘Save’.

Page 36: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

36

Setting up the Patient Files

Page 37: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

37

From the main Reference File Maintenance screen, click on the ‘patient’ tab as shown below, then click ‘new’.

Page 38: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

38

On the General Information tab, complete the required information.

Page 39: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

39

On the Primary Insured tab, complete the required information and click ‘save’. Then click ‘close’ in the bottom right corner.

Page 40: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

40

Creating Professional ClaimsWaiver and Targeted Case Management

Page 41: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

41

Click on ‘Enter Claims’.

Page 42: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

42

On the Patient Info & General tab, complete the required fields. Do not click ‘save’ when completed.

Page 43: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

43

On the Insured Information tab, the required fields should automatically populate.

Page 44: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

44

On the Billing Line Items tab, complete the required information, then click ‘save’.

Page 45: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

45

Creating Professional ClaimsCMS 1500

Page 46: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

46

Click on ‘Enter Claims’

Page 47: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

47

On the Patient Info & Codes tab, complete the required information.

Page 48: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

48

On the Insured Information tab, All required information should automatically populate.

Page 49: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

49

On the Billing Line Items tab, complete the required information and click ‘save’.

Page 50: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

50

Creating Institutional ClaimsNursing Facility

Page 51: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

51

Click on ‘Enter Claims’

Page 52: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

52

On the Patient Info & Codes screen, complete the required information. Do not click save when completed.

Page 53: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

53

On the Billing Line Items tab, complete the required information. Do not click save when completed.

Page 54: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

54

On the Payer Info tab, the information should already be populated.

Page 55: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

55

On the Diagnosis/Procedure tab, complete the required information.

Page 56: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

56

On the Extended Payer tab, complete the required information, then click ‘save’.

Page 57: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

57

Preparing Claims for Transmission

Page 58: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

58

Click on ‘Prepare Claims’

Page 59: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

59

‘LOB’ drop-down box should say ‘All’. Click on ‘Prepare Claims’.

Page 60: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

60

How to view results:

Page 61: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

61

Transmission Detail Report

Page 62: Welcome PC-ACE Pro32 Training 2008. 2 What is PC-ACE Pro32? Free software (when downloaded from the internet) IME and EDISS supported HIPAA compliant.

62

Contact EDISS to send a test submission claims batch.You will need to have 10 sample claims set up to test. Once this has been completed successfully, you will be moved to ‘Production’ status. You will then be able to start submitting claims for payment.