Prime
Clinical Systems, Inc.
3675
E. Huntington Drive, Suite A
Pasadena,
CA 91107
January
28, 2013
Dear Client,
Do you know how to check if your
claims are reaching the clearinghouse?
The OnStaff
and the Intellect programs produce
Electronic Billing (EB) reports
each time the program attempts
to send claims to your clearing
house. THESE REPORTS DO NOT MEAN
THE CLAIMS HAVE SUCCESSFULLY TRANSMITTED
TO THE CLEARINGHOUSE, they simply
are a tool provided to give you
a list of the patients who are
to be billed or should be included
in the batch of Electronic Claims
to be transmitted.
We URGE
you to ALWAYS review your Electronic
Billing Reports and verify the
report against the Electronic
Billing reports from the clearinghouse.
Clearinghouse reports can take
anywhere from 24 to 48 hours to
be posted.
These
reports should
include ALL the patients from
the EB report that OnStaff or
Intellect produces, and must be
carefully reviewed by your staff
for errors/rejections. All rejections/errors
must be corrected and those claims
re-billed for further adjudication.
Within
48-72 hours, the Payer Reports
will be posted. These reports
must be carefully reviewed by
your staff, matched-up with the
first two reports, and any rejections/errors
corrected and re-billed for further
adjudication.
Is your
office sending directly to Medicare?
Is your office Checking the Medicare
999 and 277CA reports daily?
ALERT:
If your
office is contacting EDI and Medicare
is stating that the claims were
never received at their end, there
may be several reasons:
1.
The claims were transmitted and
rejected at the 999 level. Your
office will not receive any further
correspondence from Medicare and
the claims are deleted from their
system.
There
was a connectivity problem. This
may mean that there was an issue
making the connection via your
modem to Medicare's system or
visa-versa.
2.
If your office is sending Electronic
Claims to Medicare Direct and
does not receive a 999 REPORT
or a 277CA report for the claims
that are being transmitted, either
via automation or via your staff,
within 2 days, you MUST resubmit
your claims for further adjudication.
For
additional information on 999
and 277CA reports, log-in to our
website www.primeclinical.com,
click on the [Newsletters
& Email Notices] button,
then 5010. From there,
select either 277CA Codes
or 999 Report and make
your selection.
Please
do not hesitate to contact Prime
Clinical support should you have
questions.
Thank
you,
Prime
Clinical Systems, Inc.
Support
and Training
|
