Octagon Systems Freeport Page

SEE EXPECTED SETUP BELOW

FREEPORT PRIDE

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