EMC/837
WPS Medicare offers a variety of electronic services to providers, third party billers, and clearinghouses. Services provided are:
- Electronic Claims Submission (EMC).
- Electronic Remittance Advice (ERA).
- Direct Data Entry via the Fiscal Intermediary Standard System (FISS).
Some benefits to submitting electronic claims are:
- Quicker Payment - The payment floor for a clean electronic claim is 14 days versus 28 days on clean paper claims.
- Accuracy - Electronic billing requires claims edits, which ensures that claims are submitted with fewer billing errors. This results in a faster payment to providers.
- Tracking Capabilities - 997 confirmation reports provide verification that your file(s) has been received. This report is available 24 hours after your file has been received.
Batch Billing Options
The following options are available for batch billing:
HIPAA Compliant Free Billing Software PC-ACE PRO32
PC- ACE Pro32 is free billing software, available only to WPS Medicare providers, to perform batch billing. PC-ACE PRO32 is HIPAA compliant and supported by the Centers for Medicare and Medicaid Services (CMS). Please select the PC-ACE link for more information.
Clearinghouse/Vendor
You may enter into an arrangement with an electronic claims clearinghouse or billing vendor for the transmission of Medicare claims. Please select the Clearinghouse/Vendor link for more information.
Connectivity Options for Batch Billing
WPS offers the following Connectivity options for batch billing:
Connect Mailbox - Asynchronous and Bisynchronous Connection - This is a modem to modem connection through dial up.
The minimum requirements for this application are:
- EBCDIC Characters
- Bell-compatible modem(ex: 208B Modem Half Duplex)
Helpful Hints for Connect Mailbox Users
Frequently Asked Questions regarding the Password Changes for Connect Mailbox
NDM - Network Data Mover through the main frame
The minimum requirements for this application are:
- No minimum number of claims required
- Fully IBM- compatible microcomputer with an 8088 or higher microprocessor
- Hard disk with at least 4 megabytes of available space
- Hayes-compatible modem(1200-9600 BPS)
- At least 450k of available low memory
VisionShare, Inc
- VisionShare is an internet-based connection.
- VisionShare’s connection is through a Secure Exchange Software (SES) and is HIPAA compliant.
- You must have a connection with VisionShare in order to send or receive files through their connection. If you would like to use VisionShare for EMC or ERA and do not have a connection with them, please contact VisionShare, at 1-888-895-2649, before submitting any of the EDI forms.
Forms
Data Transmission Questionnaire for Electronic Media Claims or Electronic Remittance Advices
Submit this form to establish a new connection to submit Electronic Media Claims (EMC) or receive Electronic Remittance Advices (ERA) via Connect Mailbox or VisionShare. If you select the VisionShare option, please do not submit this form unless you already have a connection to VisionShare.
Authorization to Add Providers for Electronic Media Claims or Electronic Remittance Advices
Submit this form to add providers to an existing Connect Mailbox or VisionShare connection to submit claims (EMC) or receive Electronic Remittance Advices (ERA).
Authorization to Switch from Connect Mailbox to VisionShare for Electronic Media Claims or Electronic Remittance Advices
Submit this form if you are transmitting files through an EDI/HAR Connect Mailbox and would like to switch to the VisionShare connection to submit claims (EMC) or receive Electronic Remittance Advices (ERA). You must have a connection with VisionShare before submitting this form.
Electronic Data Interchange (EDI) Form
Unless a change of ownership has taken place, you will not be required to complete an additional Electronic Data Interchange (EDI) Enrollment form for your provider number if you have previously submitted one with WPS Medicare.
276/277
The 276 and 277 transaction sets are intended to meet the specific need of the health care industry. The purpose of the 276 transaction is to obtain the current status of the claim within the adjudication process, which includes the necessary information for the payer to identify the specific claim in question. The 277 Health Care Claim Status Response is used to transmit the current status within the adjudication process to the requestor.
HIPAA IG Guide and HIPAA Companion Documents
http://www.cms.hhs.gov/electronicbillingeditrans/
Link directly to the CMS website for access to all of the HIPAA companion documents.
http://www.wpc-edi.com/
Link directly to the Washington Publishing Company's (WPC) website for HIPAA-related code lists, including Claim Adjustment Reason, Remittance Remark, Denial, and Rejection codes.
EMC Updates
Important Information Regarding the Medicare Part A Inbound Reject Report
New Error Message on Reject Report HB997ZRJ-A
Electronic Data Interchange (EDI) Media Changes
Healthcare Provider Taxonomy Codes (HPTC)
Reporting Of Taxonomy Codes To Identify Provider Subparts On Institutional Claims
Sharing of mailbox number and password for Clearinghouses/NSVs
HIPAA Reject Report User Guide
WPC
Link directly to the Washington Publishing Company's (WPC) website for HIPAA-related code lists, including Claim Adjustment Reason, Remittance Remark, Denial, and Rejection codes.
Page Last Updated:Monday, 09-Jun-2008 13:35:06 CDT
