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Last Modified: 7/18/2011
Location: FL, PR, USVI
Business: Part A
Introduction to PC Print
Medicare Part A does not send a Standard Paper Remittance (SPR) to entities that receive an Electronic Remittance Advice (ERA). Entities submitting a new request for enrollment of ERA will be allowed to receive the SPR in addition to the ERA for a limited 31-day period.
JSM-412 instructed fiscal intermediaries to terminate issuance of SPRs to those entities (such as a provider, billing agent, clearinghouse, or other entity representing a provider) currently receiving or who begin to receive electronic remittance advices (ERAs), effective the 31st day after initial issuance of the ERA in production. If a Medicare Part A provider uses a billing agent, clearinghouse, or other entity to obtain the ERA, the same guidelines will apply. If a provider number is set up to generate an ERA, First Coast Service Options will not generate a Paper Remit.
The PC-based ANSI ASC X12.835 translator program, PC Print, is an interactive program. It allows the viewing and printing of the Medicare Part A Electronic Remittance Advice received by the Provider in the form of an ANSI ASC X12.835 Electronic Remittance Advice.
The primary purpose of the program is to produce a paper remittance advice containing all of the data residing within the ANSI ASC X12.835 4010A1 Electronic Remittance Advice transmission. The intent of the paper remittance advice is to facilitate accounts receivable processing for the end-user, a provider, who does not have access to sophisticated data processing facilities. Also, the purpose is to produce a paper remittance advice acceptable for subsequent payers processing when electronic links capable of ANSI ASC X12.835 transmission do not exist.
Benefits of the PC Print program
• Viewing facilities exist to display a Single Claim. A compressed font is incorporated in order to display the detail line item activity of a claim.
• The All Claims display will allow the operator to view all of the claims in a 25 claim count increment, within the transmission in an abbreviated format. The All Claims display allows for left and right scrolling in order to view the entire Header and Detail of each claim displayed.
• A Summary Subtotal/Total Bill Type, Bill Summary, will display the sub-totals for each payment category, per provider fiscal year and the total remittance found within the Single Claim display, accumulated and displayed by TOB (Type of Bill).
• A Payment Summary, Provider Summary, identifies the total paid to the Provider for this billing cycle/transmission. It also indicates the total claims within the billing cycle/transmission. Non-claim payment adjustments are displayed when applicable. These adjustments allow for Provider payments when claims are not present, for example, Periodic Interim Payments, Cost Report Settlements, etc. The adjustments also allow for various other financial transactions required between Fiscal Intermediaries and Providers.
The PC Print program allows the end user to view or print all of the above displays. These displays can be used selectively in all situations.
Comments
PC Print has specific requirements for X12 835 files. Before using the PC Print software, you MUST contact the Medicare EDI department 888-670-0940 option -4, so your file can be given the required segment delimiters. Without these delimiters, your file will not open in PC Print. If you are a PC-ACE Pro32® user, you will not need to use PC Print. Please consult your PC-ACE manual for further information.
Note: The PC Print environment has limitations on the size of a data file used. It has been determined that a data file with greater than approximately 80,000 segments will not appropriately process in this PC Print Software. FISS does not recommend using files greater than 80,000 segments.
Source: JSM 412
