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EMC Format - Importing a file

These steps are performed each time you import a file:

  1. Copy the Electronic Medicare Claim (EMC) file to be imported into the “Impub92” folder for Part A or the "Imp1500” folder for Part B to the “WINPCACE” directory on the local drive. The EMC file must be named “EMC192.DAT” for Part A and the Part B file must have a “.dat” file extension.
  2. From the PC-ACE Main Toolbar, click on Institutional Claims Processing or Professional Claims Processing.
  3. Click on Import Claims.
  4. Click on Import to initiate the claim import operation. As the import proceeds, running totals of the count and dollar value of all imported and rejected claims are displayed on the Claim Import form. You will be notified when the claim import operation completes. Claims are rarely rejected during import into PC-ACE. The most common reason for rejecting a claim is that the claim is a duplicate of an existing "unprocessed" (UNP) claim in the "to be transmitted" (CL) location. This can sometimes occur if the same file is inadvertently re-imported into the system.
  5. Click on View Results and/or View Rejects to view the accepted and rejected claim reports, respectively. These reports can be printed from the report previewer, if desired.
  6. When you have completed your review of the claim import reports, click on Close.
  7. Click on Process Claims from the Institutional/Professional Claims Menu to open the Automated Claim Processing form.
  8. Leave the LOB, TOB, and Provider fields blank.
  9. Click on the Reprocess claims with errors block. If this option is unchecked, only unprocessed claims (status “UNP”) will be considered eligible.
  10. Click on the Present claims with errors for immediate editing block. This instructs the automatic processing engine to pause each time a claim with errors is processed and to present the claim for immediate consideration in the Institutional/Professional Claim Form.
  11. Click on Process and confirm your intention to process the claims.
  12. If desired, click on View Results and/or View Errors to view reports of the clean claims and claims with errors, respectively. These reports can be printed, if desired. When you have completed your review of the claim processing reports, click on Close.
  13. When ready, transmit claims.