PC-ACE user guide section 4

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Home ► PC-ACE user guide section 4

Last Modified: 1/4/2024 Location: FL, PR, USVI Business: Part A, Part B

PC-ACE User Guide

SECTION 4 – Importing claims into PC-ACE from another software

Claims are introduced into PC-ACE by either entering them manually or by importing them from an external source. The claim import method is ideal for facilities that maintain their claims in an upstream claims management system. Using the PC-ACE versatile claim import capabilities, these claims can be quickly and accurately loaded into the PC-ACE database for subsequent processing, preparation, and transmission. This eliminates the need to manually enter the claims.

Providers should verify with their software vendor what electronic version their claims are created in before proceeding.

Two external claim import sources are available:

• Electronic Media Claims (EMC) Format - Claims can be imported directly from a file in the EMC format. PC-ACE currently supports UB92 Version 5.0, UB92 Version 6.0, and ANSI-837 file formats for Institutional claims. Professional claim import formats include NSF 1.04 thru NSF 3.01 and ANSI-837.

• Print Image (PrintLink) - Using PC-ACE's advanced PrintLink mapping technique, claims can be imported from a print image file produced by your system. An example of this would be the file looks like a UB92/1500 claim form. This option is not supported by First Coast. For more information or for mapping services, please contact ABILITY at 888-460-4310

The following steps are required before claims can be imported from an EMC file into the PC-ACE software program:

• Click on the word File from the PC-ACE main tool bar and then click on Preferences.

• Click the appropriate Claim Import Preferences. For facilities (Part A), click Institutional Claim Import or for providers (Part B) click Professional Claim Import.

• Click the appropriate Claim Import Processing Method. For Print Image click Import from print file… or for EMC format click Import claims from file in EMC format.

• Click OK.

• Click on the word File from the PC-ACE main tool bar and click on Preferences again.

• Hold down the Shift key and press the number 7 at the top of the keyboard (not on the keypad). This will display additional tabs.

• Click on the System tab and place a check in the Enable Institutional or Professional ANSI-837 Claim Import option. Click on OK.

Refer to the following instructions for importing claims in the format you are using.

• EMC Format

• Print Image

Reverse the most recent claim import run

On occasion, it may become necessary to reverse the most recent claim import operation. This will remove imported claims from the database. Claims can only be reversed if they remain unprocessed ("UNP" status). Ineligible claims must be located and deleted manually from the Claim List form.

Follow the steps below to reverse the most recent claim import run:

1. From the PC-ACE Main Toolbar, click the Institutional/Professional Claims Processing icon.

2. Click on the word Maintain from the Institutional/Professional Claims Menu toolbar and click on Reverse Claim Import. This will display the Claim Import Reversal Utility form.

3. Select the Reverse most recent claim import operation option and click on Continue.

4. The Claim Import Reversal Confirmation form will be displayed. This contains a list of all claims imported in the most recent run. To delete all claims, click on Check All Claims to mark all claims from the previous claim import run for deletion.

5. Click on Delete Checked Claims to perform the deletion.

6. When the reversal operation completes, the Claim Import Reversal Confirmation form will close automatically.

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