Texas Medicaid ANSI 5010 Institutional

We have been approved for Texas Medicaid ANSI 5010 institutional claims.  We should be approved for professional claims in the next couple of weeks.  They mention it will take some time for us to show up on the approved vendor list on their end.  You do not have to wait for us to be on the list.  You just need to sent an email to the following address, stephanie.kinnison@tmhp.com, asking to be setup in 5010 ANSI production for institutional claims.  Include a copy to EDI5010Support@tmhp.com.  In the email mention that you use Allegheny Software Publishers, Inc. as your software vendor.  We will post when we are approved for professional claims.

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Error Message When Entering Employees

If you have Version 5017 and you get an error message when you try to enter Employees, you will need to get Version 5018.  Sorry for any inconvenience.

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New Members of Allegheny Software

There have been several personnel changes at Allegheny Software and I feel it’s important to let you know what’s happening and introduce you to the new members.

Allegheny Software has added two new members to the HHC3000 team and moved a part time employee to full time..  First is Julie Smith, who was hired to help manage cloud servers, help with technical customer support, coordinate software requests and manage accounts receivable.  Julie’s background was mainly with teaching college level on-line IT classes.  She also has a doctorate degree in information & communications from Robert Morris University.  Second is Brian Lenze, who also was hired to manage and maintain cloud servers, help with customer support and software development (programming).  Brian’s background is more hardware and technical oriented and has been recently working for national sporting goods chain with facilities the Pittsburgh, PA area.  Brian is a graduate from the Pittsburgh Technical Institute.  In addition we have moved Jennifer Molnar from part-time to full time.  Jennifer has been and helping with ANSI electronic billing which she will continue to do in the future along with additional responsibilities involving software programming.  Jennifer is a recent computer science and math graduate from the University of Pittsburgh.

Missy Sylvis, who was with us for many years in our customer support and programming area, left in late December to do full time mission work, a long time desire of hers.  She currently is in Russia.  My brother Jim Fitzgerald, who was an extremely gifted programmer, passed away in February after a long battle with cancer.  These two employees were an major factor in our company and we miss them both.  This couldn’t have happened at a more difficult time, right during the implementation of ANSI 5010 billing.  Now that the majority of ANSI 5010 implementation is complete and behind us we are feeling a sigh of relief.  The final hurdle in this area will be to put the final touches on Medicare secondary billing.

With the new team in place our emphasis will be to dwindle down the software change requests that have been growing over the past 4 to 5 months.  We appreciate the patience you have given us during this transition period.  Thanks.

Dave Fitzgerald

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Error Generating Payroll

If you get an error generating payroll telling you that field OPTIONALBASETYPE is not found, you will have to update to version 4997 or higher.  If you currently have version 4994 through 4996 you will need to update.

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Medicare Hospice – ANSI 5010

In version 4996 there was a change to HHC3000 to correct a problem with ANSI 5010 Medicare Hospice billings.  The problem occurred when an occurrence code was entered under the  patient insurance screen.  The code was being dropped when it was received by Medicare.

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DC Medicaid HHA/PCA Care Plan

We have made the changes to the 485 sections and 485 printout of software to incorporate the final revisions made by DC Medicaid to their HHA/PCA Care Plan.

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PECOS

There is a new PECOS file dated 3/5/2011 available on the internet. This filed can be downloaded from within the Doctors section of the program.

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Payroll by Patient Location – Federal Empowerment Zone

An agency in Ohio asked us to give them the ability to generate a report that shows by employee the gross payroll incurred visiting each patient along with the patient address. They were possibly eligible for substantial tax credits for payroll amounts earned in federal tax credit zones. We added a new check box in the Payroll Date Visits Paid Report that will print the report with the required information. The new checkbox is labeled “Patient Address / Location Format (for Federal Empowerment Zone Reporting)”. We thought other agencies might be interested.

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Medicare Secondary Billing

If you are having problems getting Medicare secondary billings accepted under ANSI 5010 billing you will need to get the most recent update, 4961. Under the PPS Billing Information, in the Medicare Secondary tab, there is a new field called “Claim Adjudication Date.” You will need to complete this new field in order for your claims to be accepted.

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DC Medicaid Waiver ANSI 5010

If you are having problems with DC Medicaid Waiver accepting your claims in the judication process, there are a few setup items that must be done in insurance company maintenance. In the ANSI tab check the API Format check box. API stands for atypical provider. In CLM6 select ‘Y’. For CLM12 select ’03’. In the insurance company demographics where is says NPI Override (API) enter your provider number. You should also be at version 4956 or higher. If you still have questions give us a call. Thanks.

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