Generating claims without accept assignment

Technical problems with Medisoft.
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mattparliament
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Joined: Tue May 03, 2016 1:01 pm

Generating claims without accept assignment

Post by mattparliament » Tue May 10, 2016 2:43 pm

Hey everybody, I'm new here but not to Medisoft, we've been using it for 11 years now. Anyways here's the problem. We generate a text file to import claims to our clearinghouse. In the last couple of months about 10% of the claims generated don't have the accept assignment field properly filled. It leaves it blank even though their case is set up properly. It does do it to the same patients consistently. However, NO change was made to their case and it just started doing it randomly, previous claims were generated properly. As you can imagine this made a mess, patients received payments instead of us the provider. I guarantee the cases and practice are set up to accept assignment and to force acceptance. Now, I need to scan the text file to see which ones are glitched and fix them on the clearinghouse website before submission. Is the glitch from corrupted data or is there a simple fix. I hope I've described the problem accurately, if any questions or insight please advise. If I need to schedule a Medisoft repair it isn't a problem we just need it fixed as it has cost us a bunch of time and $$$. Thanks guys!

Matt

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Gavin Walker
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Re: Generating claims without accept assignment

Post by Gavin Walker » Wed May 11, 2016 2:11 pm

If I were to take a guess, you are submitting your claims via print-image which is prone to this type of error (called a mapping error). If you are doing print image, the solution is to switch to ANSI 5010 claims with Revenue Management. We currently charge $150 for an ANSI 5010 electronic claim Revenue Management setup for the first practice and clearinghouse. For some clearinghouses, we can do this for FREE.
Gavin Walker
Walker Tek Solutions, LLC
866-890-6777
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mattparliament
Posts: 2
Joined: Tue May 03, 2016 1:01 pm

Re: Generating claims without accept assignment

Post by mattparliament » Wed May 11, 2016 2:41 pm

thanks for the response. I've discovered part of the problem which was on our end but some claims are still flawed. Yes we submit claims with print-image currently. We have looked into using revenue management and electronic EOB's but haven't taken the leap. Is there a tutorial on how to use the program both for creating the claims and importing/applying the electronic EOB's? Thanks again!

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Gavin Walker
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Re: Generating claims without accept assignment

Post by Gavin Walker » Wed May 11, 2016 3:45 pm

Hi, I sent you the Revenue Management user’s guide for Medisoft in a separate email.

There are a few problems you will run into.
  • 1. The documentation only shows you how to set this up for RelayHealth. If you use a different clearinghouse, then you will need to get the ANSI 5010 companion guide from your clearinghouse and do anything that is different in there from the RelayHealth instructions.
    2. I show you have Medisoft Basic. While you can setup Remittance Posting on Basic, it is not recommended because Basic lacks the Deposit Entry window. When an EOB is processed by Revenue Management is creates a deposit record, but without Deposit Entry you cannot go back and see how things were applied (or easily make corrections) after the fact. While Revenue Management does have before and reports you can print off, you should ideally also have Deposit Entry available if necessary.
Take care!

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