user guide
Contents
1. Pregnancy LMP Q Illness First symptom None If patient has had same or 1 J similar illness give first date Dates patient unable to visit current ocuppation References 1 4 Hospitalization dates related to current services Lee Patient s Condition Related to 0 Auto Accident 0 b Employment lt REFERRING PRI Resubmit Code 1 Prior Authorization Number Other Accident 4 Another Party Responsible Remarks Medicare Homebound Indicator Go to www secureedi com Ready Referring Provider ID Taxonomy Code Referring Provider Last Org First Middle Type Rendering Facility This is required when the service is rendered in a different place from the patient s home or the provider s office References Use these fields to specify the information of the provider that referred the patient Medicaid Resubmission Code Use this field to specify the code assigned by Medicaid or any other payer in a previous claim in the case you are resubmitting Prior Authorization Number This is required when the services on this claim have been preauthorized Or involve a referral Generally the preauthorization referred numbers are the numbers assigned by the plan UMO to authorize a service before it s rendered UMO Utilization Management Organization is generally the entity in charge of making the decision in regards to the results of the revision of the health serv2. z Batch No 20060221001 Primary Plan PAYER PLAN Claim Date 2 21 2006 10 45 47 Rendering Prov INM TEST VENDOR2 Y Claim 0000000001 Filing Indicator FILING INDICATOR Prov INM TEST VENDOR2 Facility FACILITIES Insured Patient Patient ID Number 21 4 Name Last First Middle Birth Date Sex Patient s Relationship to Insured PATIENT RELATIONSHIP TO INSURED gt Go to www secureedi com The claim form contains various sections that can be identified by the following classifications Claim Information Claim Detail Information Other claim information Other Plan Information and Ambulance Spinal Information 10 SECURE PROFESSIONAL CLAIM USER GUIDE Claim Information In this section you will enter information related to the Primary Plan the provider who rendered the service and information related to the patient insured BATCH NUMBER This is a reference number used to group the claims You can have a maximum 100 claims in a batch CLAI M NUMBER This is the claim number or the account number of the patient This is generated automatically in ascendant order however it can be replaced with any value you prefer you are using manually entered values please remember that this number must be unique BILLING PROVIDER Select the Provider for which you are billing The list will show all p
3. USER MANUAL i Figs 1 ESS 1 SECURE 2006 2007 SECUREEDI Corporation right reserved WWW Secureedi com TABLE CONTENTS INTRODUCTI ON BEFORE STARTI NG INSTALLATI ON STEP 1 INSTALLATION CONFIRMATION STEP 2 SELECT THE INSTALLATION 002 0 00 0 STEP 3 CONFIRM 5 4 4 1 1 1710006 0600000 00000007734 10012022202020000 INITIAL SET UP AND GURATI ON MAI N TOOL BAR NR EK NEW CLAIM SAVE CIAM New Gl IST RCRUM TE PT RT Pn es nn er e EN ILIO en ie a Cains usce digo RERUM ONS TU AOM aO ean Claims Details Ambulance Spinal REGU GS aici ier erepti xor e verd Go to SECUREEDI Website 00000 Send RECEIVE
4. from the display menu SECURE PROFESSIONAL CLAIM USER GUIDE A screen will then appear displaying a list of the errors one by one Use the NEXT and PREVIOUS buttons to move forward and back while you review the errors Report This report acknowledges receipt of the batch by the Clearinghouse and shows the Clearinghouse s Accept or Rejected status for all claims in the batch Change the order of the column You may change the order of the columns using your mouse through the Drag and Drop windows functionality You can also drag the columns to the dark grey area where the Batch button is to group the claims by the dragged column This is very useful if you want claims of a specific plan a specific date or a specific status To take off the group you only have to drag the name of the column to the original position Claim Forms This option will display a form that allows you to create new claims or edit existing claims A sample image of this screen is shown below Q Secure EDI Secure Claim Professional File View Actions Tools Help i New Batch New Claim c Print HCFA 1500 kJ Save Claim Send and Receive 3 Exit B Oo 3 4 A nnne levee ce FO oo HealthiInsurance Professional Claim Form a Caim Informat Claim Detail Info Other Claim Info Other Plans Info Ambu Spinal Info amp i m ARA EORR AE 122321 2 22 22 22222212 2 5 2 5
5. Details Will display ze Cick tho Download button automatically alerting wood pam wd be cimed a The upgrade wil dowrinsded and you of the new Mew Version 1 0 60 e Your application is now running on the available updates Release 3 43 51 PRODUCTION Senmerd p Upgrade hinge you installation atc all y to the PRODI TO server If you have any open claim at the moment iesu indir you execute the revision of new MM versions it will display a message indicating that the current claim must be saved first If this happens click on Save Claim and proceed After this process a window will display containing the information related to the new version update or patch as well as displaying the description of new features contained in the update Press the Download button to start the process of downloading the update Press Remember Later if do not want to apply the update at this moment If an upgrade is critical the application will not allow you to update later and will require that you download the update at this point Print Options New Batch Print HCFA 1500 Ctrl P Print the current claim Check print options New Claim This selection will allow you to print the HCFA 1500 form or in a black and white format Save Claim
6. NES To enter values for a service line put the mouse on the first field of the first line When the registry is empty it will show a star on the left side When the registry is modified this symbol changes to a Date s of Service Click on date field and then click to display the list A calendar will appear to pick the corresponding date This also reduces data entry errors by selecting from the calendar 12 SECURE PROFESSIONAL CLAIM USER GUIDE Facility Select the place of the service corresponding to the procedure specified in this line CPT HCPCS Enter the procedure code or use the F5 key to display a list of the valid CPT HCPCS codes These codes will be validated against the valid codes list for the date the service was rendered Modifier You can specify up to 4 modifiers for each procedure code These modifiers will also be validated against the official list of codes for the date the service was rendered Diag Code This refers to the position of the diagnosis code associated to the procedure code The values are the digits 1 to 8 Price Unit Rate This field is to enter the price or rate designated for each payer The rates will be read from the data base when the produce code is selected date or modifier and then after the claim is saved the rates that were used will be updated so they are the ones to appear for the next claim For the procedure codes previously used a rate will be suggested based
7. Print HCFA 1500 Ctr P 23 SECURE PROFESSIONAL CLAIM Connection Info USER GUIDE The window of options that will appear will allow you to check and change your connection configuration o Secure EDI Secure Claim Dental Configuration Connection and Activation Info server Name Production hd Connection Dial Up Connection LAN t Dial Up UserName Change Password Password Activation Rey IDCAEATDFSE 46418EAEB22759B Account Mame INM TEST VENDOR E Note Register Cancel Select the name of the server that will handle the transmission Select PRODUCTION to transmit real transactions to payers and plans Please note if enrollment is required or has been requested and not approved the claim will reject To change the test server TEST to production PRODUCTION or vice versa it is not enough to select the name from the list of servers and press OK it will be also necessary to register for the server you just change to For this open the ORGANIZATION and click on REGISTER The server change will ONLY take place after receiving the message Registration completed successfully If you receive an error during this process the server change request was not completed and you must try again or contact SecureEDI technical support Connection Select LAN if your internet connection is through broadband connection e g DSL or Cable dedicated circuit or wireless Intern
8. and exit the application SECURE PROFESSIONAL CLAIM USER GUIDE Action Claims Tracking This is the default first screen that appears after you login Secure EDI Secure Claim Professional amz File Vew Actions Tools Help New Batch Er New EL Print HCFA 1500 secure CLAIM version 1 0 Batch Batch Int Num Claim Date Payer Patient Charges User Status Errors amaba Go to www secureedi com Claims count 0 filter is applied Collapse Expand Click on the plus sign to collapse or expand the details of a specific batch use this to hide or display details at your convenience Order by Columns Click on any column header to sort a desired column Group by columns Click and hold on any column header and drag it to the upper pane above column headers and then release the mouse button to drop the column This will cause the rows to be grouped by the column you chose To disable the group by functionality simply drag and drop the selected column back to its original position View Errors After each transmission errors may be received and reported by the Clearinghouse or from the payer directly When there are errors the claims and or batches will be displayed in red and the ERRORS column will show a number greater than 0 To see number of errors in the batch click with your mouse right button and select View Errors
9. ied eue LL LA La DLL HEUS TOOLS MANAGE MEMBERS societal dest aote MANAGE PROVIDERS honte ta MANAGE REFERRING ORDERING PROVIDERS eerte nnns MANAGE CONTROL NUMBERS MANAGE PAPER CLAIMS PAYERS MANAGE PROCEDURES RATES 10 IMPORT AND EXPORT MEMBERS OPTIONS cccccescceccscesscccsccessecesccessccessceetecesseeeseceseseaccesecessceaceesseceasenueens 23 MANAGE DIMER GC FORMS eet carinae n 23 CHECK FOR UPDATES ann Iona 23 PRINT OP THON c 23 2 gt rtm e Aceto d 24 HELP 25 ABOUT 25 LEFT PANE MENU BAR 26 CEA ue eget NC MI LM ELM LA DLL CU MM M ELI 26 MEME mme 26 old a RENTUR KE 26 resign RETE 26 PRS CSS isis eg apenas Matec M M ERR 26 TROUBLESHOOTING 27 TECHNICAL SUPPORT 28 SECURE PROFESSIONAL CLAIM USER GUIDE 1 Introduction This guide is designed for Medical Healthcare Providers and Software Vendors that use SecureEDI to perform electronic transactions following the standards for privacy and security as well as f
10. CD3 Codes incremental synchronization will Procedure Codes take place automatically changes in the data after the last synchronization however when this menu option is used the synchronization performed is a complete synchronization All data regardless of where it was changed or not choosing this option will not cause problems even if data was not changed Go to SECUREEDI Website 1 uU rofessiona This screen will allow you to ot access our website the ua Internet where you can follow up Farm your claims ERA other E Sedand Rece 268 0 transaction services Goes to www secureedi com Claims Tracking Synchronize Payer CPAVERS M M Kember Mo 19 SECURE PROFESSIONAL CLAIM USER GUIDE Send and Receive Select this option to start the transmit and receive process as described previously in the description of the Tool Bar Send Receive option 7 Tools Members Look Up Members Please select the desired member from the list Select a Payer 6 y This screen is used to create a new Member No Last Name Fist Name member or edit existing members They Clear Fields i Po tet can be filtered by payer Member No Last Name First Name Create New Member Edit Member Close Billing and Rendering Providers Provider
11. anization or individual to whom the application has been licensed as well as copyrights and registered trademarks 25 SECURE PROFESSIONAL CLAIM USER GUIDE 10 Left Pane Menu Bar Actions New Bach a m E e a 0 4 E Claims Tracking Claim Form He Actions Mew Batch 2 C Request Aia Claims Claim Tracking The functionality of this button is the same as that in the Actions Claim Tracking menu option described previously Claim Form This will open the Claim form window Eligibility Request This will open the Eligibility Request window described previously when the Action Eligibility request menu option was described 26 SECURE PROFESSIONAL CLAIM 11 Troubleshooting Error 401 12045 Account is locked 12002 12029 12031 Descriptions HITP Status Denied HTTP Invalid Certificate Authority This account can not be used again unless it is released by SecureEDI contact customer service HTTP Connection Time Out HTTP Cannot Connect HTTP Connection Reset 27 USER GUIDE Comments Invalid username and or password specified The required digital certificate has not yet been installed in your PC Please verify the installation process for instructions on how to install this certificate A connection could not be established due to a slow communicatio
12. e OE window and exit the application SECURE PROFESSIONAL CLAIM USER GUIDE 6 Menu of the Main Window File New Batch This will create an empty batch so that a new claim or claims can be added A batch can continue to have claims added until it has been saved and transmitted 33 New Batch Creates a new group of claims Mew Batch Cti B New Claim Save Claim Print HCFA 1500 Cti P New Claim This will add a new claim to the current batch It will display the Claim Form For details see CLAIM FORM section New Claim Ctrl N Creates a new claim form Save Claim Ctn 5 Print HCFA 1500 Cti P Save Claim Once the claim form has been filled out click on this button to save it to the hard disk of your PC It will cause the Claims Tracking screen to be displayed If there are no errors the claim status will change to saved It is then ready to be transmitted Save Claim Ctrl 5 New Bat Saves the current claim Mew Clai T Save Claim Gn 5 Print HCFA 1500 Print HCFA 1500 This option will allow the provider to print the bill in a printable 1500 format or in a white and black format Mew Batch New Claim red 3 Print HCFA 1500 Print the current claim Check print options Save Claim Print HCFA 1500 Exit Click on this button to close this window
13. end in order to press the Send and Receive button If you do not have any claims to transmit you will only try to receive status about the claims that are being processed and see the message Waiting for Ack or Processing If there are open claims with Open or Editing status it will display the window that appears above indicating that you should save these claims giving the option to cancel the process or continue Select Yes to cancel the process and return to previous screen or No to continue If you choose to continue the open claims will not be transmitted During the communication process with SecureEDI a window will display indicating the status of the transmission as it is shown in the following image Secure EDI Secure Claim Dental Additionally you will receive from Starting Transmission SecureEDI status changes confirmation Prenarina Batch 01 0 messages and updates for Master Providers SecureClaim Codes Procedure Codes All the claims received by SecureEDI go Updating Database 30 through special validation process 17 Related Entities before being sent to the payer to ensure Master Providers accuracy and avoid rejections b IED3 Codes 9 Procedure Codes If an error is found only the claim s with and error will be rejected and the others will be transmitted to the designated payer s This button will open this guide Click on this button to close th
14. et connection Select Dial Up if the connection is performed through a telephone line 24 SECURE PROFESSIONAL CLAIM USER GUIDE Note When a telephone line is used you can choose the option Hang Up after Sending and Receiving This will allow the line to be freed automatically after the send and receive process is finished allowing the line to be free for other devices that may be sharing like fax point of service terminal etc User Name Password Activation Key a Enter Username Password and Activation Key provided by SecureEDI after your registration process If you have already changed your initial password please enter the current one here b To change the current password click on the Change Password button and complete the required additional steps C Click on the REGISTER button to register for the server you will be submitting transactions to TEST or Production You must always press this button when changing the server from TEST to PRODUCTI ON and vice versa 8 Help This option will open the user guide gt 2 ed ee SECURE Version 2 0 2 amp 2005 2006 Secure EDI Health Group Corp All rights reserved The Secure EDI Logo and Secure Claim are either registered trademarks or trademark of Secure EDI Corporation Powered by Inmediata This product is licensed to 9 About This option will display the application version activation key and the org
15. he purchased service provider Number if necessary enter the number that Medicare assigned to the facility to buy lab test Ordering Provider nformation This field provides information about the providers that order services to be billed To search for a provider of the service that had ordered a service verify in the magnifying glass located next to the indicated field You can do your search by provider number or last name DMERC CMN Oxygen This option will allow you to select the durable medical equipment or oxygen therapy that the patient requires After you make your selection press OK Before you can use the CMN forms you must go the option Tools Manage DMERC CMN Forms Amount Paid Enter the amount paid by the patient if applies When the required fields for a line of service are completed click on the ENTER key to add that line Repeat the same steps to add other service lines 14 SECURE PROFESSIONAL CLAIM Others Claims Information USER GUIDE Secure EDI Secure Claim Professional Wits File View Actions Tools Help 1207 suejo Awabia Claim Detail Info Rendering Facility when different than Home or Office Name address of facility where services were rendered Facility FACILITY TYPE gt City State Zip Code 211 4 Other Claim Info Other Plans Info Ambu Spinal Info Other Date of current 4 mim dd yyyy Q Injury Accident
16. ices or the owner of the information Remarks This is free text up to 80 characters to provide any additional information or notes of this claim such as NEA attachment numbers Other These are situational fields Please select a date if applies clicking on the search button or press F5 If the patient s condition is related to an accident job other accident or third party responsibility 15 SECURE PROFESSIONAL CLAIM USER GUIDE Select a date from the calendar and select a related cause according to the following criteria Date of Current Injury Accident Illness First symptom Pregnancy LMP or None Other Plans Information This section will allow the provider to specify secondary and tertiary plans Secure EDI Secure Claim Professional Jeg File View Actions Tools Help 04 New Batch New Claim c Print HCFA 1500 Save Claim 5 Send and Receive L3 Help 35 Exit 5 version 1 0 swej Claim Information Claim Detail Info Awaba Secondary Plan Identification lt PAYER PLAN gt TY Tertiary Plan Identification PAYER PLAN v Name 0 Go to www secureedi com I dentification Select the name of the plan from the list If the desired plan is not listed please select the option from the menu Tools Manage Providers to add the ID of the provider s for the plan you want to selec
17. ing drives Folder Volume Sac EE Disk Cost Select the location and folder where you would like the installation done or press the NEXT button to use the default location SECURE PROFESSIONAL CLAIM Step 3 Confirm Installation qe Secure Claim Professional SECURE CLAIM 44 PROFESSIONAL Confirm Installation The installer ready to install Secure Claim Professional on your computer Click Nest to start the installation Cancel Previous E M Note USER GUIDE Click Next to start the installation process Click on the PREVIOUS button to return to the previous step or CANCEL to cancel the installation If you receive a message indicating that a file cannot be replaced ignore the message and click CONTINUE to continue the installation At the end of the process click on the CLOSE button to close the window and finish the installation process SECURE PROFESSIONAL CLAIM USER GUIDE 4 Initial Set up and Configuration Select Server and Connection Type When using SecureClaim to test the sending of claims please select TEST as the Secure EDI Secure Claim Professional Configuration Connection and Activation Info ServerName Production server name To use Connection Dial Up Connection SecureClaim 10 send your LAN actual claims select Dial Up PRODUCTION Production is the normal default setting UserName For the connection ty
18. k to ensure you do not have your keyboard s CAPS LOCK button selected If you encounter any difficulties please contact technical support at the email address cs secureedi com This product is licensed to TEST VENDORZ DCAEA 1DF5E 48418 EAEB2 27698 5 Main Tool Bar New Batch New Batch Create a new batch number Please type the batch number ar click the Generate button Batch Mumber Generate Never show this screen again Always use Automatic Generate option This setting can be changed later from the Tools gt Options Menu Save Cancel Secure EDI Health Group Corp All Rights Reserved Click on the LOGIN button or press ENTER to continue This option will allow you to create a new batch of one or more claims You will now be asked for the number you would like to assign to this new batch or if you desire this number to be generated automatically If you would like SecureClaim always generate the numbers automatically you can indicate that you do not want this question to be asked next time Simply check the SECURE PROFESSIONAL CLAIM USER GUIDE appropriate box to ensure select this option You can change this selection at any time in the future via the Tools Options menu New Claim This option will allow you to add a New new claim to the selected batch The appropriate claim form will be displayed For details ab
19. n about using multiple SecureEDI products on the same computer SECURE PROFESSIONAL CLAIM 3 Installation Step 1 Installation Confirmation te Secure Claim Professional Welcome to the Secure Claim Professional Setup Wizard toes 2 SecuRe CLAIM PROFESSIONAL The installer will quide you through the steps required to install Secure Claim Professional on your computer Click Next to continue WARNING This computer program protected by copyright law and international treaties Unauthorized duplication ar distribution of this program any portion of it may result in severe civil or criminal penalties and will be prosecuted to the maximum extent possible under the law Cancel Note SEF USER GUIDE Click on the NEXT button to continue the installation process or press Cancel to close this window and cancel the installation process It is recommended that you close any applications or programs that are open before continuing the installation of SecureClaim Medical Step 2 Select the Installation Directory Secure Claim Professional at Secure CLAIM d PROFESSIONAL Select Installation Folder The installer will install Secure Claim Professional in the Following folder To install in this folder click Next To install to a different new or existing folder enter ane below ar click Browse C Program Files SecureE DI You can install the software on the follow
20. n line Please try again A connection could not be established to your ISP network using this account information The connection with your ISP network was lost Please try connecting again SECURE PROFESSIONAL CLAIM USER GUIDE 12 Technical Support nternet For consultation on our products and solutions to uninstall components or updates use our website at http www secureedi com EMail Send an email message to our technical support staff for assistance with installation or use of SecureClaim to cs secureedi com SecureEDI Corporation SecureEDI Empire State Building 350 5th Ave Suite 6408 12 New York N Y 10118 Tel 212 629 9673 Tel 800 466 9676 Fax 702 974 6855 28
21. ndition of the patient Hospital Admission Date Date of Admission in a hospital Transport I nformation Code Select the code that indicates the type of transportation Reason Code indicating the reason of the transportation Distance Range in miles during the transport 17 SECURE PROFESSIONAL CLAIM USER GUIDE Eligibility Request This section is used to check patient eligibility for plans You will receive an answer in real time approximately 3 to 15 seconds Secure EDI Secure Claim Professional File View Actions Tools Help New Batch 79 New end Receive e gi S secune CLAIM ee version 1 0 a mn Dn amm gt Heaithinisurance EligiDility check Request gay BihDae R Request Eligibility mm dd yyyy Show Advanced ptions Response Benefit information Status Po Plan Description CX Effec and Exp Date First and Mid Name C Birth Date Address Address2 City State Zip Code Go to www secureedi com In addition it will allow you to export the information from the eligibility check directly to the Manage Members window in the Tools menu for added convenience Payer Select from the list the plan for which you will make the eligibility request Member No Enter the ID of the insured or depende
22. nt Please enter it exactly as it appears on the patient or dependent s insurance card Add to member This option will allow you to export the information obtained from eligibility to the members profile Use the option Create Member Tools Manage Members section and fill out all the fields to make the creation of claims easier Birth date Enter the patient s birth date Group Number Enter the group number from the patient s insurance card 18 SECURE PROFESSIONAL CLAIM USER GUIDE Sex Select the patient s gender from the list Show advance options When you access this option you will have access to the advanced entry fields related to MEDI CARE eligibility Member Last and First Name enter the last name and the first name of the main insured Eligibility Date enter the date of service Dependent Last and First Name Enter when the ID holder is not the primary insured Service Type Indicate the type of service Synchronize This process synchronizes the local database with SecureEDI The data that 15 synchronized may include information about the account medical plans provider list procedure codes diagnosis codes etc Secure EDI Secure Claim Professional Downloading Data 100 19 Related Entities Master Providers Codes Procedure Codes Updating Database 304 rv Related Entities mE W haster Providers After each transmission an b I
23. on the last time that the procedure was used for the plan selected These values can be changed at the time the claim is created or using the option Tools Manage Procedure Rates to change the master Days Units This is to enter the amount of days or units used for this procedure Charge This is the total value billed for this line of service This is a result of total of calculating the rate price by the units days units of the procedures used This value can not be modified Measure This is to select Units International Units or Minutes Other I nformation This section is available to provide information for the claim when it applies to the service performed Please read below for details about this section Other Lab This field provides information to indicate when the service is rendered at a place different from the home or office 13 SECURE PROFESSIONAL CLAIM USER GUIDE Name You can search the name of the entity in the icon with the magnifying glass located at the right of the selection To create a new facility press the button that states New outside facility to edit the information about the existing selections press Edit Outside Facility New outside facility 1 Select the type of facility 2 Enter the name of the facility Address City State Zip Code with no separation lines between 5 to 9 digits 3 Enter the CLIA Clinical Laboratory Improvement Amendment of 1988 4 Enter t
24. or transactions and code sets as promulgated by HIPAA Health Insurance Portability and Accountability Act of 1996 Secure Claim allows Medical healthcare providers to facilitate the Electronic Data Entry of There are additional functionalities which may not be included in this documentation Secure Claim is meant to be simple to learn and use however if you require assistance at any time using any of the features of SecureClaim please contact a SecureEDI representative For Continental USA Call 800 466 9676 Fax 917 591 8247 or email customer service at cs secureedi com 2 Before Starting To assure success with this application and configuration process please make sure that your system complies with the minimum requirements for this application These requirements are listed below Hardware Requirements Pentium Processor 366MHz or Higher 64 MB RAM Minimum 128MB or above recommended 30 MB Minimum Hard Disk space available Broadband or dial up Internet connection Software Requirements Microsoft Windows Operating System 95SE 98SE Me NT 2000 XP or Vista Internet Explorer 5 5 SP1 or higher Important Note Secure Claim does not coexist with other installations of either SecureClaim or SecurEDILink Only one version of SecureClaim Professional SecureClaim Medical SecureClaim Institutional or SecureEDILink can be installed per machine Please contact SecureEDI customer support should you need any additional informatio
25. out how to complete the claim form please see the CLAIM FORM section Save Claim Once you have completed the FA e save Claim claim form click on this button to save it to the batch Once saved the Claims Tracking window will display If there are no errors found the status will be shown as Saved Your claim is now ready for transmission Send and Receive m Use this button to begin Scd and the transmission of your claim s All the claims with status SAVED will be transmitted to the respective payers through Secure Claim Clearinghouse Remember you can enter claims at any time even if you are not connected to the Internet and send them the next time you have a connection to the Internet This allows you to enter claims at any time The Following batch es have opened please save regardless your rrent that those claims before trying to transmit the batchis Internet connection status Batch Opened Claims s Once ibo are connected you can hit Send and Receive and all the claims you Opened Claims n Only Ehis Ehese batch es will be sent Batch Saved Claim s entered since the last time you hit this button will be Cancel Send Receive transmitted SECURE PROFESSIONAL CLAIM USER GUIDE Help Exit Also this process can be used to receive the statuses on previously transmitted claims You do not have to have any claims to s
26. pe Change Password 4 Password o select LAN for connections ActivationKey using broadband Internet Account INM TEST VENDOR dedicated line 11 FT1 or a wireless connection Select Dial Up for connection through a standard telephone line Register Cancel Note Registration requires that you have an internet connection available Specify the access information Enter the information related to Username Password and the Activation key as they were provided by SecureEDI before the installation process began If you do not yet have this information please contact technical or customer support or send an email to cs secureedi com Once you complete the information required press Register to begin the registration process SECURE PROFESSIONAL CLAIM Login USER GUIDE Please enter the Username and Password that you used during the registration process If you changed your password using the SecureEDI website or during the registration process please remember to use the new one here 4 WeCCITe FEES www L un 7 SECURE CLAIM Dental Please enter your Username and Password Mate that Passwords are case sensitive Please be advised that the Password is case sensitive meaning that what appears in capital letters should be entered in capital and what appears in small letters should be entered in small letters Please chec
27. red the service 11 SECURE PROFESSIONAL CLAIM USER GUIDE FILING INDI CATOR Select an indicator from the list according to the type of plan that you are using to submit the claim for example commercial plan Medicare Part A Part B HMO PPO Champus etc FACILITY Select the Place of Service from the list Claims Details Information In this section you should enter information related to the diagnosis codes procedure codes and service performed Secure EDI Secure Claim Professional File Actions Tools Help New Batch New Claim Print HCFA 1500 i Save Claim Send and Receive Help Ext CEJ M 2 3 i swego Healthiinsurance Professione Claim Information Claim Detail 1 Other Claim Info Other Plans Info Ambu Spinal Info Diagnosis or Nature of Illness or Injury D NE E 14 414 14 Date s of Service To From Awqbia Amount Paid u a Go to www secureedi com Ready DIAGNOSIS NATURE ILLNESS OR INJURY A maximum number of 8 diagnosis codes are accepted The diagnosis codes are validated against the actual version of the CD 9 CM for the date on which the service was given Click on the search button or use the F5 key to display the list of valid values form the ICD 9 CM table Diagnosis codes should be entered without any periods or dashes SERVI CE LI
28. roviders that have been checked as Billing during setup Details about this indicator may be verified on the providers management section available through the menu option Tools Manage Providers INSURED I D NUMBER You may enter the subscriber number or select it from the database by clicking on the search button When you choose search a list of all the registered members will be displayed for the plan payer selected If there are no members selected or if the member you are looking for do not appear in the list you may need to create that registry for the payer plan selected After it is created you may include it in the claim as it was explained above Because the insured s information is a value required by HIPAA all claims must contain this value Therefore is necessary to register this information about the insured and about the patient when you are registering a new member PRI MARY PLAN Select the primary Payer Plan from the list If it does not display any Payer Plans in the list then you must create them using the Tools Manage Providers option from the main menu You should also complete the provider s information for providers associated with the plan s Once this information is completed you may return and select the primary Payer Plan where you wish to send the claim RENDERI NG PROVI DER All providers marked as Is Rendering will be displayed on this list Select from this list the provider that rende
29. rs and Zip Code Click on the SEARCH button to display a list of valid states to choose from Valid Zip Codes are 5 or 9 digits only please do not enter dashes EI N SSN Enter the provider s Federal Tax Identification Number or Social Security Number Billing If this is a Billing Provider then there must be a check mark If this provider will never be a rendering provider such as a hospital provider group etc please leave this check mark off Taxonomy Code Please specify the standard specialty code for this provider also called the Taxonomy Code Entity Type Select the Person Organization according to the type of provider Accepts Medicare Assignment provider accepts Medicare assignments enter a check mark Active Use this check mark to enable disable a provider When the provider is not active his name will not appear on the providers list in the claim form 21 SECURE PROFESSIONAL CLAIM USER GUIDE PAYER I NFO Payer Infa Payer pum Plan Description Identifier Quahhes Select plan b G2 from the list Plan Description Enter the specific plan description dentifier Enter the provider identification that the payer plan assigned If you have more that none provider number for the same payer plan add the additional identification numbers here as well Qualifier For default this qualifier will be G2 You can leave this value or selec
30. s Please select the desired provider from the list Provider Mo Las Name ti This option will allow you to manage the information required for billing providers and for providers that rendered service rendering providers as well as information about the medical plans the providers are affiliated with Create New Provider Edit Provider Close Listed in this window are registered providers for the facility or office To edit the information for a specific provider click on the provider name to select it then click on EDIT PROVIDER The provider management form shown below will be displayed You can also double click on the selected provider to open the provider management form To create a new provider click on CREATE NEW PROVIDER Click on the button CLOSE to close this window 20 SECURE PROFESSIONAL CLAIM USER GUIDE PROVI DER MANAGEMENT Provider Management Last Org First Middle Last Org First Middle Enter the Provider Last Address 1 Pod Name Organization Address 2 Td name followed by first City State Zip Code CCT CAL and middle name when 88M Em Rendering applicable Taxonomy Code 5 Entity Type ENTITY e Medicare Assignment Address1 Street Name and Number Address2 Building Name Suite number if applicable City State Zip Code Enter the City Name State 2 characte
31. t I nsured ID Number Select the patient insured for the selected plan If the patient insured does not appear on the list you can add it using the button Create new option After all the required fields are completed in this claim form click on the SAVE button to validate and save your claim This will add it to the current batch with the SAVED status Every time you open a claim that has already been completed the status will change to EDITING 16 SECURE PROFESSIONAL CLAIM USER GUIDE Ambulance Spinal Information This screen is used to enter the information of ambulance and spinal manipulation if applies 6 Secure EDI Secure Claim Professional View Actions Tools Help New Batch E New Claim ELE Print HCFA 1500 pes Save Claim i Send and Receive Help ME Exit Claim Information Detail nfo Other Claim Info ee Ambulance Patient Information Weight Lbs Condition PATIENT CONDITION Hospital Admission Date 1 4 Amaya Ambulance Transport Information Code TRANSPORT CODE Reason TRANSPORT REASON gt Distance Miles Spinal Manipulation Information Condition Code CONDITION CODE itia Treatment Date ays Date Acute Manifest Date 4 wanes q Go to www secureedi com Ready Patient nformation Weigth The weight of the patient at the time of service Condition Code indicating the co
32. t any other qualifier if required by the payer plan Press ENTER to add an entry Repeat the process to add another identification number with another payer or medical plan Press OK to close the provider management window and save the current information or press CANCEL to exit without saving the changes Manage Referring Ordering Providers Option that will allow you to indicate or change the information of the doctor that orders the service Manage Control Numbers This selection is exclusive for SecureEDI technical use Manage Paper Claims Payers The functionality of this option is to configure payers that are not receiving electronic bills yet only paper Manage Procedures Rates With this Tool rates can be administered for the plans You can modify the ones generated by the use of the SecureClaim In addition you can manually add and delete rates prices by payer 22 SECURE PROFESSIONAL CLAIM USER GUIDE Import and Export Members Options Allows you to export members to a text file Manage DMERC FORMS This field is used to complete or edit new CMN s forms Check for Updates Use this option to manually check for the existing new versions updates or patches to the Secure Claim application or when instructed by a technical 4 Upgrade Information E support amk representative When there is a new version available window Product IMClaim Pius Professional v2 0
Download Pdf Manuals
Related Search