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Required Setup Information for Filing ANSI Formatted Insurance Claims

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Abstract:

To avoid errors when processing electronic claims using the ANSI format, ensure that the following information has been properly set up in OfficeMate/OfficeMate Administration:

  1. In the Business Names window, on the Business tab, ensure that a Contact is recorded.

  2. In the Business Names window (OfficeMate v8 or below), or in the Resources Setup window (OfficeMate v9 or above), on the Provider tab, ensure that the following information is recorded:
    -License Number
    -Tax ID Type
    -Tax ID Number
    -UPIN
    -Provider Type
    -TPA
    -DEA
    -EMC Submitter ID (if you are a GatewayEDI client, this ID is your site number)
    -Insurance Information (All insurance carriers assigned to the provider must have a Pin, Group, Submitter ID, and assignment information recorded. If there is no group number or submitter ID assigned to the provider, you can leave these fields blank. In OfficeMate 7.0 and above, if you do not record a submitter ID for the provider, the Pin will be automatically placed in box 24k on the CMS 1500 form.)

  3. In the Business Names window (OfficeMate v8 or below), or in the Resources Setup window (OfficeMate v9 or above), on the Referring Physician or Referring Dr. tab, ensure that the UPIN and EIN numbers are recorded.

  4. In the Business Names window (OfficeMate v8 or below), or in the Insurance Billing Initial Setup window (OfficeMate v9 or above), on the Insurance or Insurance Carrier tab, ensure that the following information is recorded:
    -Name
    -Address
    -City, State, Zip Code
    -Phone Number
    -Insurance Type
    - Blue Cross (1A)
    - Blue Shield (1B)
    - Champus (1H)
    - Commercial (G2)
    &n

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