Billing EDI Secondary Insurances with Medisoft
Many have posed the question, how do you send secondary claims electronically? Or, for that matter, how do you send attachment information or cancel and replacement claims electronically?
To answer this question, first it is important to recognize there are two ways to send electronic claims; print image or ANSI 4010. If you are sending in the print image format (and the clearinghouse is converting to an ANSI 4010), you need to ask yourself in which box would you put this additional payment information on the CMS-1500 form? If your answer is, I couldn't. I would have in the past attached a piece of paper to the claim, then your answer is you can't send secondary, attachment or cancel and replacement claims electronically using a print image file.
So, that leaves us to the ANSI 4010 format. If you are converting your claims from Medisoft (or another software) to the ANSI 4010 format then you need to answer two questions: 1) Which loop or segment in the ANSI 4010 do I need to put this information? (you usually need to get this from the insurance carrier requesting the attachment or look in the ANSI 4010 guide) and 2) Where do I put it in my software? For Medisoft, it's easy to find where to put the information, go to Help on the top menu bar within the program, click on Medisoft Help (first option down) and then in the Index tab enter the Loop and Segment you need and there is a crosswalk showing where to put the information into Medisoft. If you have another software program, you need to ask the software vendor for a ANSI 4010 crosswalk.
Finally, how do you get the ANSI 4010 format? For Medisoft, it's really simple, it's called the Simple 837 format and the price is $495. Included with your purchase, Billing Buddies will install, register and train you how to transmit your claims. From start to finish, it takes about one hour to review the process. To get started, call us at 888-322-2455.
Happy Billing and Charting,
Bonnie J. Flom
To answer this question, first it is important to recognize there are two ways to send electronic claims; print image or ANSI 4010. If you are sending in the print image format (and the clearinghouse is converting to an ANSI 4010), you need to ask yourself in which box would you put this additional payment information on the CMS-1500 form? If your answer is, I couldn't. I would have in the past attached a piece of paper to the claim, then your answer is you can't send secondary, attachment or cancel and replacement claims electronically using a print image file.
So, that leaves us to the ANSI 4010 format. If you are converting your claims from Medisoft (or another software) to the ANSI 4010 format then you need to answer two questions: 1) Which loop or segment in the ANSI 4010 do I need to put this information? (you usually need to get this from the insurance carrier requesting the attachment or look in the ANSI 4010 guide) and 2) Where do I put it in my software? For Medisoft, it's easy to find where to put the information, go to Help on the top menu bar within the program, click on Medisoft Help (first option down) and then in the Index tab enter the Loop and Segment you need and there is a crosswalk showing where to put the information into Medisoft. If you have another software program, you need to ask the software vendor for a ANSI 4010 crosswalk.
Finally, how do you get the ANSI 4010 format? For Medisoft, it's really simple, it's called the Simple 837 format and the price is $495. Included with your purchase, Billing Buddies will install, register and train you how to transmit your claims. From start to finish, it takes about one hour to review the process. To get started, call us at 888-322-2455.
Happy Billing and Charting,
Bonnie J. Flom
Thanks for taking the time to share this, I feel strongly about it and love learning more on this topic. If possible, as you gain expertise, would you mind updating your blog with more information? It is extremely helpful for me.
Reply to this