PayerLink User`s Manual
Contents
1. DDE File Transfer Eligibility A pop up security warning about installing software will appear Click Install to continue access to DDE This message will only appear one time Interne eplorer Security Warning iso you want to instal this software Publisher Ericom Softee mea Cortina Mahis Piles fron Pe Internet can be u hi fe batt can pierda ham OF COEN Oriy retal software From publishers you trust Whai Hews pick 9 Page Revised 08 19 2013 PayerLink User s Manual 2013 Wait as components are downloaded and installed This could take several minutes depending on the internet connection speed fA A TN3270 158 73 213 27 T3MK0077 PowerTerm WebConnect HostView oe File Edit Terminal Communication Sessions Options MEIRLE CMSHNSGi0 Centers For Medicare amp Medicaid Services CDS Enterprise Data Center ccecceccecceccccce H M SSSSSSSSSSSSSS cc MMH HHH 99S sss MHM MM MM MM Sss SSS MM MM MM MM sss MM MMM HM SSSSSSSSSSSSSSS MM M MM sss MM MM sss cc MM MM sss sss CCCCCCCCCCCE HM MM ssssssssssssss UNAUTHORIZED ACCESS TOO THIS COMPUTER SYSTEM IS PROHIBITED BY LAW REF TITLE i8 U S C SECTION 1030 This is a CMS computer system and is provided for the processing of Official U S Government information AII data contained herein is owned by CHS and for the purpose of protecting the rights and property of CMS may be monitored intercepted recorded read copied or captured2. PayerLink User s Manual 2013 Table of Contents PTO UAE PayerLIN kK serenas eE A Eea a 2 Internet SCC G S ci ctscpaectepeneiernapunnimrenestivanaausssudeniatnpmargeosspasiehmamaitayvand tcaavamesmmenixancnsaidne 4 koco DN se sscancrreapcttrate ead ening E ta seas A ontonanieehcokenmensnenidanents 8 DDE eer eee ree E eee ee eee re 9 Fue Trans E e O eee ee ee eee eee eee 11 Uploadine US asa precepts a EEE EEE E EEA 13 Downloading Viewing Response FIileS c ccccseseecece ee eeeeeeeeeeeeeeeeeeeeeeeaaaane 15 Accessing AL CHIV EG Fil Ssimeiosioii EEEa AEE Eai 17 TRANS ACCOM Lop oeeisssoninidneisianess n a r inai 18 BNC Y soesaccrestereepee senescence TE E A E i T 19 Viewing Previous Eligibility ReSpONnses ccccccscceece cee eeeeeeeeeeeeeeeeeeeenene eas 22 SAS CS e A E E N 23 Printing Saving and Viewing Eligibility Responses 24 Account Opos crcire iiieoo atiera Eini 33 Reser PIS 00 of osina n ee E E E 34 Loo ME ON oa daaantessaauidebersgeuetiessonenuasieatinneetasinnnhes taseuienianns 36 1 Page Revised 08 19 2013 PayerLink User s Manual 2013 About PaverLink PayerLink provides connectivity to CMS systems including FISS DDE for Part A providers PPTN for Part B providers VIPS for DME providers HETS for Medicare eligibility and EDI for transfer of electronic claim files 837 and remittance files 835 FISS DDE or Direct Data Entry PPTN and VIPS are terms associated with the access of CMS claim data
3. Save Preventive Codes New Codes None Removed Codes None Eligibility Inquiry Name HARRISON HOPE Direct NPI 1518914175 Current STC Codes 15 Alternate Method Dialysis 10 Blood Charges BG Cardiac Rehabilitation DM Durable Medical Equipment 12 Durable Medical Equipment Purchase 18 Durable Medical Equipment Rental 42 Home Health Care 45 Hospice 47 Hospital 48 Hospital Inpatient 49 Hospital Room and Board AD Occupational Therapy AE Physical Medicine BF Pulmanary Rehabilitation 14 Renal Supplies in the Home AG Skilled Nursing Care AF Speech Therapy 11 Used Durable Medical Equipment Save STC Codes Newly Added STC Codes Removed Codes None 84 Abortion 64 Acupuncture 28 Adjunctive Dental Services 85 AIDS 57 Air Transportation AJ Alcoholism GY Allergy 79 Allergy Testing 13 Ambulatory Service Center Facility 07 Anesthesia 97 Anesthesiologist Codes selected and saved now be the default codes for the selected customer for all future Eligibility requests After reviewing the updated information and saving you will be returned to the Eligibility home page 21 Page Revised 08 19 2013 PayerLink User s Manual 2013 Viewing Previous Eligibility Reports All previously requested Eligibility reponses may be viewed again To view previous Eligibility responses Q On the Eligibility Inqui
4. pet Password Login or recover your password Type you Email Address Click Submit Reset Password Email 34 Page Revised 08 19 2013 PayerLink User s Manual 2013 A screen will appear requesting you to Answer Security Question Answer Security Question Security Question What was vow childhood nickname Security Answer Select the Security Question from the drop down menu Enter your Security Answer Click Reset You will receive an email similar to the message below notifying you that your password has been reset From lt noreply pa erlink com gt Date Mon Mar 26 2012 at 4 53 PM Subject PayerLink Forgot Password Notification To dloftus73 gmail com Jane Doe Your password has been updated The temporary password is Wtsifd20Q You will be asked to update this password once you log in You will need to change the password after you login 35 Page Revised 08 19 2013 PayerLink User s Manual 2013 Logging Out To log out from the CMS System Click File Exit To Log out of PayerLink ly Click the logout icon AC at the top of the right of the screen After you logout the following window will appear notifying you that you have successful logged out Login to your account No account Click here Email pet Password pepe Login or recover your password 36 Page Revised 08 19 2013
5. 27 2012 135968456 other 44697 PGBA Report Item Description Start Date The date the 60 day Home Health episode period started End Date The date that the Home Health episode terminated DOEBA Date The date of earliest billing activity for spell of illness DOLBA Date The date of latest billing activity for spell of illness Provider Provider name and number will show only the NPI if the Provider name is not available Contractor A display of the Contractor number Contractor Name A display of the Contractor name not be listed on the report It is possible to have PPS period information with no DOEBA ore lf DOEBA and DOLBA dates are not available in the 271 Eligibility file retrieved they will NOTE and DOLBA information 31 Page Revised 08 19 2013 PayerLink User s Manual 2013 Hospice TheHospice section appears as follows Benefit Period Start Date Term Date Provider Revocation Code 2 5 5 2010 8 2 2010 968365789 1 Revoked by notice of revocation 1 2 3 2010 5 4 2010 968365789 1 Revoked by notice of revocation Report Item Description Benefit Period The number of the Benefit Period Start Date The start date of a subscriber s elected period of Hospice coverage Term Date The termination date of a beneficiary s elected Hospice coverage No date in this filed means the beneficiary s elected period of Hospice coverage has not terminated Provider Provider name and number will show only the NPI
6. Eligibility Transaction System is a real time eligibility inquiry system developed by Centers for Medicare amp Medicaid Services CMS HETS is updated each night by the Common Working File CWF so it contains billing data collected through the previous day This system uses the HIPAA 270 271 transaction to respond to eligibility verification and benefit inquiries HETS includes data for specific services such as home health and hospice as well as general Medicare eligibility information This data can be used to make detailed reports displaying a patient s prior billing history including providers they have seen and secondary Part D coverage 3 Page Revised 08 19 2013 PayerLink User s Manual 2013 Internet Settings Payerlink may be accessed through any browser Below are the instructions for Internet Explorer settings The settings must be configured before accessing Payerlink To configure settings for PayerLink From the internet browser go to Tools Internet options Trusted sites This zone contains websites that you trust not to damage your computer or your files Security level for this 20ne Custom Custom settings To change the settings click Custom level To use the recommended settings cick Default level _ EE Reset al zones to default level cane Click the Security Tab Click Trusted Sites a green check mark should appear Click the Default Level button The following windo
7. if the Provider name is not available Revocation Code Code indicating whether hospice coverage was terminated or not 0 indicates continuing hospice coverage 1 2 or 3 indicates the hospice coverage was terminated revoked No Data Available If No Data is available for a section the section will appear as follows Medicare Secondary Payer No Medicare Secondary Payer data available 32 Page Revised 08 19 2013 PayerLink User s Manual 2013 Account Options After logging in with the default password for the first time the password and security question will need to be changed To change the account settings On the main PayerLink screen click the account Options Settings icon 2 at the top right of the screen and click My Account Update Password old password id 6 character minimum 1 letter 1 num ber required case sensitive corm f Security Question What is your favorite sports team Update Type the Old Password Type the New Password Confirm New Password Select a new Security Question Type a new Security Answer Click Update 33 Page Revised 08 19 2013 PayerLink User s Manual 2013 Reset Password If you forget your password you can request to have the password reset To request a password reset From the Login page at https www payerlink com Click Recover your password Login to your account No account Click here Email
8. of using anther vendor to upload billing claims to your Medicare Adminstrative Contractor MAC Files are transferred to and picked up from MAC s in PayerLink on an hourly schedule Keep in mind if you create claim files 837 and upload them to PayerLink they will be visible in the outbound folder until the scheduled hourly transfer Likewise inbound files 999 277CA and 835 will not appear until the scheduled system refresh 999 response files should be received at the response file reciept time following the upload time as these files are typically processed quickly 277CA response files may take hours to a couple days to receive Submitter Numbers After entering your Submitter ID and password when requesting File Transfer there will be a delay before File Transfer is activated During this delay you will not be able to access File Transfer when clicking on the icon If your organization has multiple submitter ID numbers after File Transfer is activated you will need to enter the additional submitter ID numbers and corresponding passwords 1 On the main screen click File Transfer A Pavegshink Upload 837 Files Read Acknov yemer File Manager o 90 MTDTest 3 Archived Files amp Inbound Reports And Remits 4 amp 98765 12 999 7 17 2012 9 21 24 AM 98765 t1 999 7 17 2012 9 21 23 AM 98765 sample 277ca 7 17 2012 9 21 22 AM amp 98765 Accepted 999 7 17 2012 9 21 21 AM 3 Outbou
9. that will provide information on the subscriber s insurance 28 Page Revised 08 19 2013 PayerLink User s Manual 2013 Medicare Secondary Payer The Meidcare Secondary Payer section will contain Secondary Payer information if there is any entered and appears as follows Medicare Secondary Payer Effective Date Address Line 1 Termination Date Address Line 2 Insurer Name City Policy Number State Type of Primary Insur Zip Report Item Description Effective Date The date that indicates the start of the primary insurer s coverage Termination Date The date that indicates the termination of the primary insurer s coverage No date in this field means primary insurance coverage has not terminated Insurer Name The name of the insurance company Policy Number The primary insuring organization s policy number for the Medicare beneficiary Type of Primary Insur The type code and description of the Primary Insurance Plan 12 Medicare Secondary Working Aged Beneficiary or spouse with Employer group health plan 13 Medicare Secondary End Stage Renal Disease Beneficiary in the 12 month coordination period with and Employer group health plan 14 Medicare Secondary No Fault insurance including auto is primary 15 Medicare Secondary Workers Compensation 16 Medicare Secondary Public Health Service or other Federal Agency 41 Medicare Secondary Black Lung 42 Medicare Secondary Veteran s Administ
10. Date Type Preferred Provider Organization PPO Option MCO Bill Option Code C Name Humana Insurance Company ID H0339 879 Address Line 1 1100 Insurance Blvd Telephone 21200 N402 Hower 148 Address Line Z Tip 697586384 City St Louis Website www humana medicare com State MO Report Item Description _ Enrollment Date The date that indicates the start of enrollment to the coverage plan Type A full plan description followed by Plan Type Code HM Health Maintenance Organization Medicare Non Risk HN Health Maintenance Organization Medicare Risk IN Indemnity PR Preferred Provider Organization PS Point of Service Part D Pharmacy Name A descriptive name of the beneficiary s insurance coverage organization Address Line 1 2 The Coverage Plan s Address lines City The Coverage Plan s City Address State The Coverage Plan s State Address Term Date The date that indicates the termination of enrollment to the coverage No date in this field means the plan enrollment has not terminated Option The bill option code of the Plan Type This field only applies to plan types HM HN IN PPO and PS This field will not be displayed for Part D plan type ID The contract number followed by the plan number if on file Telephone The Coverage Plan s Contract Telephone Number if on file displayed as XXX AXX AKAXAX Zip The Coverage Plan s Zip Code Website Contract Plan s website address
11. by healthcare providers Claim data submitted to Medicare contractors is posted nightly to update the Common Working File CWF This centralized CMS file system includes a collection of all Medicare claims for the entire country Once in the CMS system if you have questions on how to use DDE PPTN or VIPS refer to your Medicare Contractor Medicare Contractors maintain user manuals for the FISS DDE PPTN and VIPS systems and are available for download from their websites Palmetto J1 Part A J1 Part B J11 HH amp H J11 Part A J11 Part B http www palmettogba com palmetto palmetto nsf SiteHome ReadForm NGS J6 Part A J6 Part B J6 HH amp H J13 Part A J13 Part B JB DME http www ngsmedicare com wps portal ngsmedicare CGS e J15 Part A J15 Part B J15 HH amp H JC DME http www cgesmedicare com Medicare html Novitas e JH Part A JH Part B J4WPS Legacy Part A J12 Part A J12 Part B https www novitas solutions com J5 Part A J5 Part B J8 Part A J8 Part B Legacy Part B for IL MN amp WI http www wpsmedicare com index shtml 2 Page Revised 08 19 2013 PayerLink User s Manual 2013 e J14 Part A J14 Part B J14 HH amp H JA DME http www medicarenhic com Noridian e JE Part A JE Part B JF Part A JF Part B JD DME https www noridianmedicare com Cahaba e J10 Part A J10 Part B https www cahabagba com FCSO Inc e J9 Part A J9 Part B http medicare fcso com HETS or HIPAA
12. cates the start of an inactive period due to unlawful deported or incarcerated reasons A date that indicates the end of an inactive period due to unlawful deported or incarcerated reasons The address line of the subscriber beneficiary if available The city of the subscriber beneficiary if available The state of the subscriber beneficiary if available The zip code of the subscriber beneficiary if available The date that indicates the start of eligibility for ESRD services The Type of Dialysis 14 or 15 services that are being rendered The Date the Transplant services were discharged 25 Page Revised 08 19 2013 PayerLink User s Manual 2013 Deductible The Deductible section appears as follows Deductible Part B Deductible Year Blood Calendar year OT Cap Calendar year 1 1 2012 12 31 2012 PT amp ST Cap Calendar year 1 1 2012 12 31 2012 Pulmonary Rehab Sessions Remaining T 72 Cardiac Rehab Sessions Remaining T a 1 1 2012 12 31 2012 1 1 2012 12 31 2012 Part B Remaining Deductible Amount 0 Blood Number of Units Remaining 3 OT Cap Remaining Amount 1680 PT amp ST Cap Remaining Amount 1880 Pulmonary Rehab Sessions Remaining P 72 Cardiac Rehab Sessions Remaining FP Int Cardiac Rehab Sessions Remaining T 0 Report Item Int Cardiac Rehab Sessions Remaining P 0 Description Part B Deductible Year Part B Remaining Deductible Amo
13. ced Settings E Select a setting for the Internet zone gt Medium Blocks third party cookies that do not have a compact privacy Blocks third party cookies that save information that can be used to contact you without your explicit consent Restricts first party cookies that save information that can be used to contact you without your implicit consent Pop up Blocker Prevent most pop up windows from J appearing Turn on Pop up Blocker InPrivate 5 C Do not collect data for use by InPrivate Filtering Disable toolbars and extensions when InPrivate Browsing a starts In the Pop up Blocker settings window type payerlink com in the Address of website to allow Exceptions Pop ups are currently blocked You can allow pop ups from specific Ei websites by adding the site to the list below Address of website to allow payerlink com Allowed sites Remove Remove all Notifications and blocking level Play a sound when a pop up is blocked v Show Notification bar when a pop up is blocked Blocking level Medium Block most automatic pop ups Na Learn more about Pop up Blocker 6 Page Revised 08 19 2013 PayerLink User s Manual 2013 Click Add click Close Also in the Privacy tab under Settings click Sites to Allow cookies in PayerLink Type https www payerlink com in the Address of website field Click Allow Per Site Privacy Action
14. cular Screening Blood Tests 80061 Lipid panels 107 Anesthesia 82465 Cholestrol 83718 Lipoprotein 84478 Triglycerides 13 Ambulatory Service Center Facility 97 Anesthesiologist All Eligibility Inquires will be set with default Preventative Care codes and Service Type codes available in the 270 and 271 files unless otherwise changed by the user Only codes being used in the inquiry will appear in the file Click O at the top right of the Eligibility Inquiry screen to modify the eligibility request 270 To add codes simply check the box next to the heading of the section of applicable codes to be added To remove codes from inquiry simply uncheck the box next to the heading of the section of applicable codes to be removed g After adjustments are completed click the save icon to continue A screen will appear allowing the user to review the changes made on the previous screen and Save as shown below 20 Page Revised 08 19 2013 PayerLink User s Manual 2013 Eligibility Inquiry Name HARRISON HOPE Direct NPI 1518914175 Current Preventive Codes G0402 G0403 G0404 G0405 G0438 G0439 G0389 80061 82465 83718 84478 62947 82950 82951 G0123 G0143 G0144 G0145 G0147 G0148 P3000 Q0091 G0101 e 77057 G0202 G0104 G0105 G0106 G0120 G0121 G0328 82270 G0102 G0103 G0117 G0118 90669 90670 90732 G0446 G0445 G0447 Q
15. ect Compress Archive Files File Manager O0 iter Su Mo Tu We Th Fr Sa Select Log Date Directory does not exist 1 2 3 7 8 9 10 14 15 16 17 21 22 23 24 228 A list of transactions will appear if files were sent and received this date 18 Page Revised 08 19 2013 PayerLink User s Manual 2013 Eligibility PayerLink generates a 270 eligibilty transaction request based off the patient information entered in the Eligibility inquiry screen PayerLink then accesss CMS HIPPA Eligibility Transaction System HETS which is available 24 hours a day 7 days a week CMS sends back a 271 Eligibility response file that PayerLink translates into an Eligibility report To access Eligibility On the main Payerlink screen click Eligibility The Eligibility inquiry screen will appear Q Eligibility Inquiry Name HARRISON HOPE Direct NPI 1518914175 Requesting Eligibility for Aternate Method Dialysis Blood Charges Cardiac Rehabilitation Home Health Care Hospice Hospital Hospital Inpatient Hospital Room and Board Occupational Therapy Physical Medicine Pulmanary Rehabilitation Renal Supplies in the Home Skilled Nursing Care Speech Therapy Durable Medical Equipment Durable Medical Equipment Purchase Durable Medical Equipment Rental Used Durable Medical Equipment HICN Member Id Last Name First Name Date of Birth Date Type From Thru Plan Date 5 29 2011 12 29 2013 Type the HICN M
16. ember ID required field Type the Last Name First Name and the Date of Birth two of these three fields are required The Date Type From Thru Code 1 Code 2 and Code 3 fields are automatically set so that the maximum values data are retrieved in the Eligibility response Click Eligibility The eligibility response will appear in a new browser tab 19 Page Revised 08 19 2013 PayerLink User s Manual 2013 The PayerLink Eligibility module gives the user control over which Preventive Care codes and Service Type codes are used when requesting benefit inofrmation for selected services These code sets can be accessed from the Eligibility Inquiry page by clicking on the pencil icon O the top right of the screen The following screen will appear Q Eligibility Inquiry Name HARRISON HOPE Direct NPI 1518914175 Service Type Codes H Q Preventive Care Codes H ee L Initial Preventive Physical Examination IPPE G0402 Initial Preventive Physical Examination IPPE G0403 EKG for IPPE 28 Adjunctive Dental Services G0404 EKG tracing for IPPE G0405 EKG interpret amp report for IPPE 64 Acupuncture 85 AIDS C157 Air Transportation C Annual Wellness Visit AWV G0438 Initial visit Me G0439 Subsequent visit GY Allergy L UltraSound Screening for Abdominal Aortic Aneurysm AAA G0389 Ultrasound exam AAA screening 79 Allergy Testing W 15 Alternate Method Dialysis Cardiovas
17. g 835 files must first be downloaded see steps above for downloading 835 files 3 Click Read Ackowledgements to view the response files The 277CA files will appear as seen below Rejected claims will appear in red shading accepted response files will appear in a green shading 15 Page Revised 08 19 2013 PayerLink User s Manual 2013 Policy 111111111F Date of service 20090828 Payer Claim Control MB ICN Policy 111111111F Date of service 20090828 Payer Claim Control MB ICN Policy 111111111F Date of service 20090828 Payer Claim Control MB ICN The 999 Claim Status accepted files will appear as shown below 98765_Accepted 999 999 Status Accepted Segment Only Errors 0 Element Errors 0 The 999 Claim Status rejected files will appear as shown below 98765 t1 999 Status Rejected Segment Only Errors 2 Element Errors 2 ntation dependent segment missi Loop 2000 HL line 3 Invalid code value on Element 4 1 Loop 2110 EQ line 11 Segment has data element errors Loop 2000 HL line 5 Required data element missing on Element 2 Im entation d ent not used segment t Loop 2000 TRN line 8 NOTE If you Double Click the inbound file itself from the File Manager screen without clicking the Read Acknowledgement button the reponse file will open however the format will not be readable In order to read the response file you must click the Read Acknowledgements button 16 Pa
18. ge Revised 08 19 2013 PayerLink User s Manual 2013 Accessing Archived Files Response files are never deleted from PayerLink They will remain as visible current files in the Inbound Reports and Remits folder for 10 days following the receipt of the response file After 10 days the response files will automatically be archived and will be available for viewing in the Archived Files folder Additionally response files may manually be archived by the user at any time during the 10 day period To manually archive response files Check the box to the left of the file to archive Click Compress Archive Files A window will appear If you do not want to compress the file Leave the filename blank Click OK If you want to compress the file enter the filename and click OK 17 Page Revised 08 19 2013 PayerLink User s Manual 2013 Transaction Log To view files in the transactions log Click to the right of File Manager Upload 837 Files Read Acknowledgements Import 835s to 835Direct Compress Archive Files File Manager a MTDTest a Archived Files amp Inbound Reports And Remits 4 oc 2876542999 7 17 2012 9 21 24 AM amp O 98765 t1 999 7 17 2012 9 21 23 AM O 98765 sample 277ca 7 17 2012 9 21 22 AM Z 928765 Accepted 999 7 17 2012 9 21 21 AM Outbound 837 Files A Calendar will appear Select the log date to view Upload 837 Files Read Acknowledgements Import 835s to 835Dir
19. ility request was received but there was an error converting it to a readable report Failed CMS Response Your Eligibility request was received from CMS but there was an error retrieving the 271 response and no report was generated 23 Page Revised 08 19 2013 PayerLink User s Manual 2013 Printing Eligibility After you click Get Eligibility and the response appears on the screen you will have the ability to print the response After the response appears two icons will appear on the top right screen Click A print window will appear Click Print Saving Eligibility After you click Get Eligibility and the response appears on the screen you will have the ability to print the response To print the Eligibility response After the response appears two icons will appear on the top right of the screen Click 7 Different browser versions will pop up various windows You may need to click Save andor Open for the response to appear in a new tab Click onthe browser toolbar to print the report Viewing Eligibility Responses Eligibility responses that Do not contain errors will contain several categories of information if they are entered including the following Agency User The Agency User section appears as follows Agency User een ABC Home HEALTHCARE Provider 111111 ayerLink Jane Doe Date Time Requested 5 31 2012 1 55PM Subscriber The Subscriber section appears as follows Name Johns Eli
20. in any manner and disclosed in any manner by authorized personnel If you are not authorized access to this system you must immediately exit 1 cos 2 HP 3 BDC 4 NONEDC 5 HP TPX T3MK0077 CDS ENTER REQUEST gt E Fi F2 F3 F5 F8 F9 Dexe ScieenCap Open ScreenCap Delete ScreerLap BB 370 Dipa 2437 On Line Select 1 For PGBA or 2 for all other Medicare Adminstrative Contractors The DDE system will only allow one user to be logged in at a time If you attempt to login when another user is already logged in you will receive an error message Note If windows Firewall is enabled the Ericom terminal progran for access will need to be enabled if notifed by windows Click the Windows Security Alert button in the taskbar at the bottom of the screen and click unblock the window This will remove any window Firewall notifications from poppong up in the future Windows Security Alert cg lo krip jumeri pou romper Wyuiyes Perea har hiort ed tree bootwes of ther proy om Do pou mam te keep tect ey thes progam Det Vere Powel em Wet onnect lipsi Vaa H dhile rrer i ere hired ro rfrrt a gt Mal vr ainda Frowal har bioc ed Ge Coogan bam scoegtrg corocon hom fe indemnat amp 6 NOAOA you boogie Pe Geog ate o vui Pee Otdiher yOu Ce whioh 2 When heed urtia a aman 10 Page Revised 08 19 2013 PayerLink User s Manual 2013 File Transfer File Transfer in PayerLink replaces the additional cost
21. le 98765_1116_ERA 8 28 2013 11 53 A 835 File iM Computer 1_RSS120626112833 ACK 8 28 2013 11 53 A ORIG File Network ball jii File name AII Files Open Cancel Select the file that needs to be uploaded Click Open On the first Upload File window click Upload File Files will be placed in the outbound folder until the file transfer update occurs 14 Page Revised 08 19 2013 PayerLink User s Manual 2013 Downloading Response Files Response files are automatically stored in PayerLink 999 and 277CA files will not need to be downloaded unless you want to store a copy of the files on your hard drive 835 files will not be able to be translated and viewed in PayerLink They must be Downloaded and then Uploaded into another 835 translation software to become human readable If you have 835Direct you may import the file to 837Direct within PayerLink Follow the steps below to download files 1 Go to the Inbound Reports and Remits folder to see a list of all the response files 2 Click the blue hyperlink for the file to be downloded 3 A file Download window will appear Click Open or Save Save As Viewing Response files You have the ability to view the response files within PayerLink 1 Go to the Inbound Reports and Remits folder to see the list of all response files 2 Checkmark the box next to each file that needs to be viewed Only 277 and 999 files will be available for viewin
22. nd 837 Files 2 The File Manager screen will appear 3 Click Add Submitter 4 Select the Medicare Administrative Contractor MAC Receiver the agency uses from the drop down menu 11 Page Revised 08 19 2013 PayerLink User s Manual 2013 5 Enter the additonal MAC Submitter ID number 6 The User Name will automatically be populated the Submitter ID when it is entered Some MAC s use a different User Name vs the Submitter ID If so type over the User Name 7 Enter your MAC submitter Password the password obtained from the former file transfer vendor 8 Retype Password close File Transfer Request Activation Receiver CGS we Submitter ID i User Name Password i Retype Password i Save and Continue Click Save and Continue You will automatically return to the main menu screen Repeat steps 1 9 for each additional submitter ID number 12 Page Revised 08 19 2013 PayerLink User s Manual 2013 Uploading Files File Transfer is available for electronic claims that have been processed in the 837 format or billing Once claims have been processed you will be able to upload files to the MAC On the Main Screen click File Transfer DDE File Transfer Eligibility The File transfer Upload screen will appear Read Acknowledgements il import 835a to 635Direct IN _ComprassiArchive Files File Manager 9 O0 n MTDTest Archived Files amp Inbound Repor
23. ration 43 Medicare Secondary Disabled Beneficiary under age 65 with Large Group Health Plan 47 Medicare Secondary other liability insurance is primary WC Workers Compensation Medicare Set aside arrangement Address Lines 1 2 The address Line of the insurance company City The city of the insurance company State The state of the insurance company Zip The Zip Code of the insurance company 29 Page Revised 08 19 2013 PayerLink User s Manual 2013 Home Health Certification The Home Health Certifiation section appears as follows Home Health Certification Certitication G0180 Certification Date 1 4 2011 Re Certification GO1T9 Re Certification Date 2 28 2012 Report Item Description Certification The HCPCS code used when the subscriber became certified for home health care services Certification Date The date the subscriber was certified to receive home health care services Re Certification The HCPCS code used when the Beneficiary became recertified for home health care services Re Certification Date The date the beneficiary was recertified to receive home health care services 30 Page Revised 08 19 2013 PayerLink User s Manual 2013 Home Health The Home Health section appears as follows Start Date End Date DOEBA Date DOLBADate Providers Provider Name Contractor Contractor Name 2 28 2012 4 27 2012 135968456 other 44697 PGBA 12 30 2011 2 27 2012 12 31 2011 2
24. ry screen click Previous Responses A list of previous responses will appear Eligibility Manager Select by Status CMS Report Success v Date of Birth Member ID Timestamp Sm A fo 8 20 2013 4 35 34 PM PG Sm A faa as 8 20 2013 4 35 26 PM P a Sm A E m 8 20 2013 4 35 14PM Click P on the row of the response file that you wish to view If the Previous Responses list is long you can click the Select by Status drop down menu to filter the list to show only the status types that you wish to view See below for additional information on Status Types Eligibility Manager Select by Status CMS Report Success sr Sm A En A 8 20 2013 4 35 34PM O Sm A E es 8 20 2013 4 35 26PM 0 sm A a ee 8 20 2013 4 3514PM 0 To go back to the Eligibility Inquiry screen click Q 22 Page Revised 08 19 2013 PayerLink User s Manual 2013 Status Types Eligibility includes four response status types These status types explain the type of response received and allow you to filter previous responses by status The Four status types include CMS Report Success Your Eligibility request was processed and sucessfully converted to a report Eligibility Entry Error One of the pieces of data you entered about the patient does nto match what CMS has in the common working file Eligibility Transaction Error No Eligibility 271 response was received due to an error from CMS Failed CMS Report Your Eligib
25. s Manage Sites g You can specify which websites are always or never allowed to use cookies gt regardless of their privacy policy Type the exact address of the website you want to manage and then click Allow or Block To remove a site from the list of managed sites select the name of the website and click the Remove button Address of website TAT Managed websites Domain Setting Remove Remove all Click OK In the internet Options window click apply Click OK to save all settings You may proceed to login 7 Page Revised 08 19 2013 PayerLink User s Manual 2013 Logging In To Login to PayerLink navigate to the web page https www paverlink com PaveyxPink Login to your account No account Click here Email pet Password Login or recover your password Type the Email and Password Click Login The PayerLink main menu screen will appear A eo DDE File Transfer Eligibility Oo 8 Page Revised 08 19 2013 PayerLink User s Manual 2013 DDE To install the DDE software on your computer you must be an administrator for the computer or have an administrator login and install the software for you If you do not have administrative rights to install software you will receive the following message Copy Eror ss A Do you want to continue Setup without copying thas file To Access and install DDE on the main PayerLink screen click DDE a eo
26. tion sessions remaining for the Technical Component The number of Intensive Cardiac Rehabilitation sessions remaining for the Professional Component 26 Page Revised 08 19 2013 PayerLink User s Manual 2013 Preventative The Preventative section contains all prevetative care and appears as follows Preventative Smoking Cessation Sessions Remaining amp Prev HCPCS Code GI43 gt Annual Wellness Visit AWW 60435 Annual Wellness Visit AWW Report Item Smoking Cessation Next Session Date Prev Next Professional Date Prev Next Technical Date 1 1 2011 1 1 2011 1 1 2011 1 1 2011 Description smoking Cessation Sessions Remaining smoking Cessation Next Session Date Prev HCPCS Code Prev Next Professional Date Prev Next Technical Date Number of Smoking Tobacco Cessation Counseling Sessions remaining for a subscriber The next available begin date for Smoking Tobacco Cessation Counseling Session program if there are no sessions in their current period A Healthcare Common Procedure Coding System HCPCS code The date a subscriber is next eligible for professional services associated with the indicated HCPCS code The date a subscriber is next eligible for technical services associated with the indicated HCPCS code 27 Page Revised 08 19 2013 PayerLink User s Manual 2013 Plan Coverage The Plan Coverage section appears as follows Plan Coverage Enrollment Date 1 1 2012 Term
27. ts And Remits 4 999 O 98765 t2 999 7 17 2012 9 21 24 AM oc 928765 419999 7 17 2012 9 21 23 AM 98765 sample 277ca 711712012 9 21 22 AM O 98765_Accepted 999 7 17 2012 9 21 21 AM Outbound 837 Files Click Upload 837 files 13 Page Revised 08 19 2013 PayerLink User s Manual 2013 A window will appear Select the Submitter ID if you have more than one Select the Claim Type Click Browse to find the location where your 837 files are stored Submitter ID WAUH EGS w Claim Type Institutional K Professional Browse Upload File The Choose File to Upload window will appear Choose File to Upload xo Q a gt Sample Files v Search Sample Files P Organize 7 New folder z I e Favorites z Name Date modified Type E Desktop Sample 102 5 201308140236460304 8 28 2013 11 55 A 8371 File J Downloads Sample 101 4 201308140229426139 8 28 2013 11 56 A 8371 File Recent Places Sample 100 3 201308140227224290 8 28 2013 11 57 A 8371 File Sample 99 2 201308150933199236 8 28 2013 11 55 A 8371 File i Libraries _ E Sample 98 1 201308150159381811 8 28 2013 11 55 A 8371 File lt Documents 98765 t2 999 8 28 2013 11 52 A 999 File Music 98765 t1 999 8 28 2013 11 53A 999 File 4 Pictures 98765 sample 277ca 8 28 2013 11 53 A 277CA File amp Videos 98765_Accepted 999 8 28 2013 11 53 A 999 Fi
28. unt Blood Calendar Year Blood Number of Units Remaining OT Cap Calendar Year OT Cap Remaining Amount PT amp ST Cap Calendar Year PT amp ST Cap Remaining Amount Pulmonary Rehab Sessions Remaining T Pulmonary Rehab Sessions Remaining P Cardiac Rehab Sessions Remaining T Cardiac Rehab Session Remaining P Int Cardiac Rehab Sessions Remaining T Int Cardiac Rehab Sessions Remaining P The calendar year associated with the remaining deductible amount Medicare Part B remaining deductible amount associated with the calendar year indicated The calendar year associated with the remaining deductible amount The Blood Deductible units remaining associated with the calendar year indicated The calendar year associated with the remaining capitation amount Occupational Therapy remaining amount associated with the calendar year indicated The calendar year associated with the remaining capitation amount Physical and Speech Therapy remaining amount associated with the calendar year indicated The number of Pulmonary Rehabilitation sessions remaining for the Technical Component The number of Pulmonary Rehabilitation sessions remaining for the Professional Component The number of Cardiac Rehabilitation sessions remaining for the Technical Component The number of Cardiac Rehabilitation sessions remaining for the Professional Component The number of Intensive Cardiac Rehabilita
29. w will appear 4 Page Revised 08 19 2013 PayerLink User s Manual 2013 internet Options _ p m a e mmn General Security Privacy Content Connections Programs Advanced Select a zone to view or change securty settings ee y 9 Internet Localintranet Trusted stes Restricted sites Trusted sites This zone contains websites that you trust not to damage your computer or your Files level for this zone Appropriate for websites on your local network intranet Most content wil be run without prompting you Unsigned ActiveX controls will not be downloaded Same as Medium level without prompts Defaut level Reset al zones to default level Slide the slider bar on the left to Medium low Click the Sites button Type http payerlink com in the Add this website to the zone box You can add and remove websites from this zone All websites in this zone will use the zone s security settings Add this website to the zone http payerlink com Websites Remove 5 Page Revised 08 19 2013 PayerLink User s Manual 2013 Be sure that the Require server verfication check is unchecked Click Add to add the site to the Trusted sites list Click Close Click the Privacy tab in the Internet Options window In the Pop up Blocker section click on the Settings button if it is enabled internet Options r General Security Privacy Content Connections Programs Advan
30. zabeth Date of Birth 7 29 1921 Gender F HICN Member Id 496093871A 24 Page Revised 08 19 2013 PayerLink User s Manual 2013 Eligibility The Eligibility section apears as follows Eligibility Part A Effective Date 7 1 1986 Part A Termination Date Part B Effective Date 7 1 1986 Part B Termination Date Inactive Period Effective Date Inactive Period Effective Date Beneficiary Address Line 1 1234 West Ozark Avenue ESRD Benefit Desc Svc Type Code Beneficiary Address Line 2 ESRD Transplant DC Date Beneficiary City Ozark ESRD Effective Date Beneficiary State MO Report Item Description Part A Effective Date Part A Termination Date Part B Effective Date Part B Termination Date Inactive Period Effective Date Inactive Period Termination Date Beneficiary Address Line 1 Line 2 Beneficiary City Beneficiary State Beneficiary Zip ESRD Effective Date ESRD Benefit Desc Svc Type Code ESRD Transplant DC Date A date that indicates the start of eligibility for Medicare Part A benefits A date that indicates the termination of eligibility for Medicare Part A Benefits No date in this field means Medicare Part A eligibility has not terminated A date that indicates the start of eligibility for Medicare Part B benefits A date that indicates the termination of eligibility for Medicare Part B benefits No date in this field means Medicare Part B eligibility has not terminated A date that indi
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