Print image - importing a file

Setup

The following steps are required before a UB92 or 1500 print image file can be imported into the PC-ACE program. This is a one-time process and should not have to be done again. First Coast does not support this option.

1. For print image importing, a “.map” file is required. For information on obtaining this file, contact Inovalon (formerly ABILITY) at 888-460-4310, option 4.
2. Once the required “.map” file is obtained from Inovalon, copy the file into the “Impub92” folder for Part A or the “Imp1500” for Part B in the “WINPCACE” directory on your local drive.
3. From the PC-ACE main tool bar, select the Reference File Maintenance icon.
4. Click on the Payer tab. Select the line for Payer ID and click on View/Update.
5. Click on PrintLink Matching Descriptions.
6. Click on New.
7. Type “MEDICARE~” as the new matching string and click on OK.

Importing a file

The following steps are to be performed each time you import a file:

1. Copy the print file to be imported into the “Impub92” folder for Part A or the “Imp1500” folder for Part B, in the “WINPCACE” directory on the local drive. The print file must be named “ub92.prt” for Part A and “h1500.prt” for Part B.
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 or 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.