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OnSTAFF 2000

 

 

 

This menu allows you to bill the financially responsible party by sending either an insurance form (paper or electronic) or a detailed statement.

 

Menu Options:

 

Insurance                    Allows billing of Insurance claim forms to the applicable insurance company.

 

Statement                   This option allows the printing of detailed statements, which are sent to patients.

 

Tele Com                    This option is used for electronic claims submission.

 

Follow-Up                   Used to generate follow-up letters to patients or insurance carriers.

 

Worker                       Used to bill charges and submit other Workers Compensation related information.

 

Pre-Billing                  Allows you to, prior to billing, for ALL charges entered, edit the information contained in the report. 

 

Exit                             Returns you to the Main Menu.

 

 

New Menu Option:     ANSI Features

 

ANSI Features is used to request from Medicare the following electronic features:

 

ANSI 997 The Functional Acknowledgment Transaction Set (997) for use within the context of an Electronic Data Interchange (EDI)environment. The transaction set can be used to define the control structures for a set of acknowledgments to indicate the results of the syntactical analysis of the electronically encoded documents. The encoded documents are the transaction sets, which are grouped in functional groups, used in defining transactions for business data interchange. Report Acknowledgement / Error Summary Report Eligibility Request Eligibility Report

 

 

Carrier Type:              4  - Medicare

 

Status:                         Pressing the [F2] search key will display the following valid choices:

 

9        ANSI 997 Report (see below ‘Sample ANSI 997 Report’)

                                                A   Error Summary Report (i.e., Acknowledgement)

                                                S    IN THE FUTURE Eligibility Request (Send request)

                                                P    IN THE FUTURE Eligibility Report (Pick up report)

 

As of version 8.2 10/06/2011, programming is completed to accommodate ANSI 5010 requirements which are effective January 1, 2012. The current ANSI 997 Report has been replaced with the new ANSI 999 Report and reads (basically) the same. There is a new Segment(s) on the ANSI 999 Report, a line(s) beginning with 'IK'; for example, the line 'IK5*A~' indicates the claim was 'A'ccepted. If the claim was 'R'ejected, this line would read 'IK5*R~'. For any 'R' (rejections) in ANY 'IK' fields/lines of the ANSI 999 Report, fax your ANSI 999 Report to PCS at 616-449-5615. Include your client ID, contact person, and phone number. Click here for a 999 Report sample.

 

Also effective January 1, 2012, the new ANSI 277CA Report (Claim Acknowledgement) replaces the current Claim Acknowledgement/RSP report which is no longer available with ANSI 5010. The 277CA file will be converted to a report form and printed. Click here for a 277CA Report sample.

 

Insurance Code:         Enter the /Utility/Insurance <Insurance Co. Code> for Medicare, press [Enter], then enter the /Utility/Insurance <Insurance Co. Code> for Medi-Medi, press [Enter].

 

Patient No.:                When using <Carrier Type> = 4 and the following <Status> options:

                                   

9        Automatically bypasses this field.

                                    A   Automatically bypasses this field.

S    Enter the account number(s) of the patient(s) whose eligibility you want verified by Medicare, then press the [é] key to continue to the next field.

P    Automatically bypasses this field.

 

Provider Code:           Optional.

 

Sample ANSI 997 Report:

Note: As of January 1, 2012, this report will no longer be available. It is being replaced by the 999 Report which reads similarly to the 997 report. See the <Status> field information for a link to a 999 Report sample.

 

 

 

HOW TO READ THE ANSI 997 Report:

 

To determine Medicare’s response as to whether your claims for the prior submission were accepted or rejected, locate the line which begins with AK9.  On that line, AK9 will be immediately followed by an A (accepted), P (passed), or R (rejected).  The above example denotes Medicare’s acceptance of a prior electronic claim submission.

 

WHEN TO USE THE ANSI 997 Report:

 

Twenty-four hours after electronic claim submission, request the ANSI 997 Report.  If the report indicates:

1.      The prior submission was accepted, you may request the Acknowledgement / Error Summary Report.

2.      The prior submission was rejected, fax the ANSI 997 Report to Software Support at (626) 449-5615.  Include your client ID, contact person, job ID, and the date the report was printed.  A reference will be opened and you will receive a call back.