PC-ACE Pro32 Training Module by 2D9wJO3j

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									    PC-ACE Pro32
    Training Module
Highmark Medicare Services
Electronic Data Interchange
(EDI)
                          1
Step One: Setting up the Program
   There are several pieces of information that must be
    entered into the program in order to submit a claim file.
   The provider data, patient data, payer data and submitter
    data should all be entered in the Reference File
    Maintenance folder.
   Proceed to the Reference File Maintenance folder by
    clicking on the third icon.




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Setting up Provider Information
   Click the provider tab for either institutional (Part A) or
    professional (Part B).




                                                                  3
Setting up Provider Information (continued)
   Then click the New button.




                                              4
Setting up Provider Information (continued)
   Complete all necessary fields and click the Save.




                                                        5
Setting up the Submitter Tab
   From the Reference File Maintenance folder, click on the
    Codes/Misc tab.




                                                           6
Setting up the Submitter Tab (continued)

   Then click the SUBMITTER button.




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Setting up the Submitter Tab (continued)
   Select Institutional or Professional.
   Then click the View/Update button if you only have one
    submitter identification (ID). If you have multiple
    submitter IDs, click the New button.




                                                             8
Setting up the Submitter Tab (continued)
   Enter all necessary information and then click Save. The
    ID field and the EIN fields should be completed with your
    submitter identification (ID) found in the EDI welcome
    letter.




                                                            9
Setting up the Payers
   PC-ACE Pro32 is already pre-loaded with the Highmark
    Medicare Services’ Payer numbers. If your patient has
    another payer as either their primary or secondary insurer,
    you must set them up in the Payer tab. From the
    Reference File Maintenance folder, click the Payer tab and
    then click the New button.




                                                           10
Setting up the Payers (continued)
   Complete the screen with the necessary information and
    then click the Save button. A separate payer screen
    must be completed for each primary and secondary
    insurer.




                                                         11
Setting up the Patients
   From the Reference File Maintenance folder, click on the
    Patient tab then click the New button.




                                                          12
Setting up the Patients (continued)
   Complete all necessary fields and then click the Save
    button.




                                                            13
Setting up the Patients (continued)
   Next complete the Primary Insured tab and then click the
    Save button. There are different tabs for institutional and
    professional. Please choose the correct one.




                                                             14
Setting up the Patients (continued)

   Next complete all necessary secondary insurance
    information and then click the Save button.




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Step Two: Entering a Claim

   After the Reference File Maintenance is complete, enter
    a claim by clicking the Institutional or Professional
    Claims Processing icon.




                                                          16
Entering a Claim (continued)


   Then click the Enter Claims icon.




                                        17
         Entering a Claim (continued)
   Complete the necessary information for your claim type
    and then click the Save button.
   Many of the fields in this screen have a pop-up selection
    feature that lists valid entries for that specific field.
   Access the list by pressing the “F2” key or right clicking
    in the specific field.




                                                             18
Step Three: Preparing a File for
Transmission

   Once the claims are saved, click the Prepare Claims
    icon.




                                                          19
Preparing a File for Transmission (continued)
  Then click on the Prepare Claims button. This will create a
   file named “trans.dat” for Part A or “transb.dat” for Part B.
   The file will be located in your “C” or other local drive
   under the WINPCACE folder.




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Step Four: Transmitting the File
   Using your telecommunications software package, connect to Highmark
    Medicare Services’ telecommunications server, SmartXfr™, using the
    transmission line telephone number 717-635-4400.
   Key in the login ID (as displayed in the screen shot below) and press Enter.
    The login ID was provided to you in the EDI welcome letter.
   Key in your password and press Enter. This will bring you to the Bulletin
    Board Menu.
   More information on connecting is available in the Connecting to SmartXfr™
    Server Guide.



             Welcome to HIGHMARK SmartXfr™ System.
             Date: 10/29/2009 - Time: 09:57

             Please type logon and password then press enter.
             Logon: LOGIN@submitter
             Password: <<enter password>>


                                                                              21
Transmitting the File (continued)
   Key “1” and press Enter to start the transmission.
   Locate your file in the WINPCACE folder of your “C” or
    other local drive.
   The files will be named “trans.dat” for Part A or
    “transb.dat” for Part B.
       Last Successful Login Date: 10/29/2009 09:56:15
       Last Failed Login Date:   10/26/2009 22:28:18
       Date : 10/29/2009         Time: 09:57
       Protocol: Zmodem
       User Id: login@submitter                    Transfer: /dev/pts/7
       Trading Partner: 1111111                    Compress: None

       1) Transmit files
       2) Receive files
       3) List files
       4) User Configuration
       LO) Logoff


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Step Five: Pulling Reports
   Using your telecommunications software package, connect to Highmark
    Medicare Services’ telecommunications server, SmartXfr™, using the
    transmission line telephone number 717-635-4400.
   Key in the login identification (ID) and press Enter. Key in your password
    and press Enter. This will bring you to the Bulletin Board Menu.
   More information on connecting is available in the Connecting to SmartXfr™
    Server Guide.


             Welcome to HIGHMARK SmartXfr™ System.
             Date: 10/29/2009 - Time: 09:57

             Please type logon and password then press enter.
             Logon: LOGIN@submitter
             Password: <<enter password>>


                                                                            23
Pulling Reports (continued)
   Key “2” to retrieve the 999 Implementation Acknowledgement or 277CA Claim
    Acknowledgement.
   Designate the directory where you want the file to be sent.
   Once retrieval is complete, locate the report in the directory that you specified.
   More information on reading the reports is available in our 5010 Companion Guide.



      Last Successful Login Date: 10/29/2009 09:56:15
      Last Failed Login Date:   10/26/2009 22:28:18
      Date : 10/29/2009         Time: 09:57
      Protocol: Zmodem
      User Id: login@submitter                    Transfer: /dev/pts/7
      Trading Partner: 1111111                    Compress: None

      1) Transmit files
      2) Receive files
      3) List files
      4) User Configuration
      LO) Logoff


                                                                                         24
Where to Get Additional Information

   Additional information on the PC-ACE Pro32 program is
    located on our Web site at:
     PC-ACE Pro32 User Guide
     PC-ACE Pro32 Quick Steps



    Or contact our EDI Help Desk.




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