Octagon Systems
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Right click and save link into C:\Program Files\OctagonSystems\ClaimMaster\Data |
Freeport Pride edi_medicaid form Save link into the directory in which their forms are stored. |
Freeport Pride edi_medicaid_secondary form Save link into the directory in which their forms are stored. |
Here are changes you probably need to make to the configuration:
Pay Rate: .5
Report Control File: CLINIC_MULT_DATES_RPT.CTL
Here are the custom fields I would have expected for a mental health clinic:
(I am assuming they want to enter more than one date per claim. If that is not correct, then I would change this.)
Insurance:
2 - special processing - value 9413 (so all its medicaid procedures will be sent as 9413)
3 - practice type - value C
4 - charge allowed amount - if they do charge the allowed amount, I would expect Y, otherwise N
6 - rate method - value 4 (means 90804 is rate 4251; 90806 and 90947 are 4215; 90853 is 4215; 90801 is 4214)
7 - use facility - value N (unless they sometimes see patients in hospitals, which is unusual for a clinic)
8 - one claim per bill - value N (if they put more than one date on a claim)
12 - use lytec refer prov id - value O
13 - use lytec prov id - value O
14 - only needed if they have 2001
Bill header:
3 - SA exception, but only if they every have service authorization exceptions, which they probably do not
Bill detail:
1 - Medicare allowed - curr - to be entered when 50% is not paid
2 - amount paid - curr - to be entered for all secondary claims, unless they charge Medicare the allowed amount. (When they charge allowed, they only need to enter exceptions.)
4 - original claim - 22 long- only needed for adjustments
Provider:
4 - Medicaid Id is license -value Y or N - enter Y when the provider type+license is entered instead of their Medicaid ID
Address
5 - Medicaid ID is MMID - values M or blank - enter M if Referring provider Medicaid ID is entered