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Welcome PC-ACE Pro32
Training
2008
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What is PC-ACE Pro32?
●Free software (when downloaded from the internet)
●IME and EDISS supported
●HIPAA compliant
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Why use PC-Ace?
●Faster claims processing
●No IME keying errors
●No scanning issues
●User friendly
●It’s free when downloaded from the internet
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How to get PC-ACEAccess paperwork at
●www.edissweb.com/cgp/forms/enrollment.html
Download and fill out forms
●Noridian Administrative Services, LLC (NAS) EDI Enrollment Form
●837P Professional Claim, or 837I Institutional Claim, or 837D Dental Claim
●Software Licensing Agreement (SLA)
Forms must be signed by the provider.
Fax enrollment forms to 877-269-1472.
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How to get PC-ACE
Download the software at
●www.edissweb.com/cgp/vendors/pcace.html
Access installation and billing instructions at
● www.ime.state.ia.us/providers/forms.html#paphd
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The Role of EDISS
●EDISS (Electronic Data Interchange Support Services) is the vendor for IME
●EDISS processes electronic billing applications, sets up accounts with user names and passwords
●EDISS troubleshoots the software
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The Role of IME
●Outreach staff at IME can train providers on the software, help providers build files and give instructions on how to install and bill
●Outreach staff can train providers either face-to-face or through a phone call
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EDISS Contact Information
Monday, Tuesday, Thursday, Friday
8-5 CST
Wednesday
10-5 CST
www.edissweb.com
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Sign up to receive the latest EDISS news
Sign up by going to:
http://mail.noridian.com/wws/subrequest/hipaasubmitter/
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Once PC-ACE Pro32 is installed, the icon on the desktop will look like the one below. Double-click on the icon to open.
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PC-ACE Pro32 Toolbar
This is the program’s main toolbar
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Reference File MaintenanceThis is where the provider and patient files will be built.
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You will be asked to enter a User ID and Password when opening the Reference File Maintenance Screen. Enter ‘sysadmin’ for both.
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Setting Up Your Provider Files
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From the Reference File Maintenance Screen, Click on ‘Codes/Misc’
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On the Codes/Misc tab, click on ‘Submitter’
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Setting up Professional Provider Files
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Click ‘Professional Option’
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Click ‘View/Update’
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On the Professional Submitted Information screen, complete the required information then click ‘save’.
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From the Reference File Maintenance Screen, click on Provider (Prof). Then click ‘new’.
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On the New Provider Options screen, choose the appropriate option.
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On the Professional Provider Information screen, click the appropriate option.
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On the Professional Provider Information screen, complete the required fields, then click on the ‘Extended Info’ tab.
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Professional Provider Information (extended info)
Enter ‘XX’ for provider ID/No Type.
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Professional Provider Information (Local Fields)Enter Submitter ID given to you by EDISS, then click ‘save’.
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Setting up Institutional Provider Files
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From the Reference File Maintenance Screen, Click on ‘Codes/Misc’ and then on ‘Submitter’.
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Click the ‘Institutional’ Option and then click ‘View/Update’.
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On the Institutional Submitter Information screen, complete the required information, then click ‘save’.
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From the Reference File Maintenance Screen, click on the Provider (Inst) tab then click ‘New’.
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On the New Provider Options screen, select the appropriate choice and click ‘OK’.
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From the Institutional Provider Information screen, complete the required information under General Info.
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On the Extended Info tab, enter ‘XX’ in the Provider ID/No Type field.
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From the Local Fields tab, enter the Submitter ID number sent by EDISS, then click ‘Save’.
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Setting up the Patient Files
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From the main Reference File Maintenance screen, click on the ‘patient’ tab as shown below, then click ‘new’.
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On the General Information tab, complete the required information.
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On the Primary Insured tab, complete the required information and click ‘save’. Then click ‘close’ in the bottom right corner.
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Creating Professional ClaimsWaiver and Targeted Case Management
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Click on ‘Enter Claims’.
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On the Patient Info & General tab, complete the required fields. Do not click ‘save’ when completed.
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On the Insured Information tab, the required fields should automatically populate.
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On the Billing Line Items tab, complete the required information, then click ‘save’.
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Creating Professional ClaimsCMS 1500
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Click on ‘Enter Claims’
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On the Patient Info & Codes tab, complete the required information.
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On the Insured Information tab, All required information should automatically populate.
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On the Billing Line Items tab, complete the required information and click ‘save’.
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Creating Institutional ClaimsNursing Facility
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Click on ‘Enter Claims’
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On the Patient Info & Codes screen, complete the required information. Do not click save when completed.
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On the Billing Line Items tab, complete the required information. Do not click save when completed.
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On the Payer Info tab, the information should already be populated.
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On the Diagnosis/Procedure tab, complete the required information.
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On the Extended Payer tab, complete the required information, then click ‘save’.
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Preparing Claims for Transmission
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Click on ‘Prepare Claims’
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‘LOB’ drop-down box should say ‘All’. Click on ‘Prepare Claims’.
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How to view results:
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Transmission Detail Report
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Contact EDISS to send a test submission claims batch.You will need to have 10 sample claims set up to test. Once this has been completed successfully, you will be moved to ‘Production’ status. You will then be able to start submitting claims for payment.
