EDI INTERMEDIARY PRODUCT INFORMATION

AdminaStar Federal, in conjunction with The Centers for Medicare and Medicaid Services (CMS), strongly encourages electronic data interchange (EDI) transactions. As a company, we offer products and services in the EDI environment beyond the submission of electronic claims. To maximize the benefits received as an electronic submitter, incorporate all of our EDI tools in your daily business routines.

E-Commerce Consultants:

AdminaStar Federal's E-Commerce Consultant has years of Medicare and EDI experience. This expertise is used to advise providers on maximizing the EDI tools offered at AdminaStar Federal. The consultant provides education on EDI and HIPAA (Health Insurance Portability and Accountability Act of 1996). She will assist providers when making decisions associated with the electronic environment and works closely with software vendors, billing services and clearinghouses to provide effective communications. You can contact your E-Commerce Consultant using the information below:

To Download the latest version of the EDI Brochure click here

MEDA DDE

The Medicare Part A Direct Data Entry (MEDA DDE) System allows on-line entry of Medicare Part A HIPAA compliant institutional claims, as well as, claim status, claim update and eligibility verification. Connection to MEDA DDE is made through a Network Service Vendor. Information on Network Service Vendors and their pricing structure is detailed on the DDE enrollment forms.

To access the enrollment forms, click here.

Outbound Reports

Medicare Part A providers can elect to receive their Provider Statistical & Reimbursement (PS&R) report, 201 Pend report, and/or Additional Development Request (ADR) letters electronically. This eliminates the delay of waiting for these reports and letters through the mail.

Electronic Remittance Advices:

Electronic Remittance Advice (ERA) enables providers to receive their remittances sooner than on paper. Along with faster receipt, some software vendors have developed the capability to post these notices automatically. The automatic posting process is reliable and efficient. Check with your software vendor to see if you have this capability. Filing claims electronically is the only requirement necessary to sign-up for ERAs.

To access the ERA agreement form, click here.

Electronic Funds Transfers:

Electronic Funds Transfer (EFT) allows automatic deposit of claims payment into a bank account specified by the Provider. When EFT is coupled with ERA, the advantages include quicker receipt of funds and notices, eliminated trips to the bank and the time savings of a manual process.

To access the EFT agreement form, click here.

PC-ACE (PRO 32)

PC-ACE (Pro 32) is an effective and easy to use software for entering HIPAA compliant institutional claims and transmitting them electronically to Illinois, Indiana, Kentucky and Ohio Medicare Part A. All Medicare Part A bill types may be entered including inpatient hospital, outpatient and skilled nursing facility. The Medicare Part A module of PC-ACE also allows entry of non-Medicare UB92 claims. Non-Medicare claims will not be included in the transmission but will print on a standard UB92 pre-printed claim form at the time the Medicare electronic file is built for transmission.

User managed tables contain vital information such as patient demographics and claim tracking. These tables assist the user in the creation of claims data quickly and accurately. By utilizing PC-ACE software, Medicare electronic claims are paid based on a 13-day payment floor versus a 29-day payment floor for paper. An annual administrative fee of $25 is required when enrolling for PC-ACE.

Minimum Hardware Requirements

• Pentium 133 Mhz processor (Pentium II - 350 for higher volume support)
• 32 MB RAM (64 MB recommended)
• 128 MB for Windows 2000 or Windows NT
• 9600 baud or greater asynchronous modem
• Dot Matrix or Laser Printer
• SVGA monitor with 800 x 600 resolution
• CD-Rom

MedAComm is the communications software included in PCAce. MedAComm will NOT work with a "cable modem" or a DSL Line.

PC Print:

Are you still using the Standard Paper Remittance (SPR)? Save TIME and MONEY by taking advantage of FREE PC-Print software available for viewing and printing the HIPAA compliant Electronic Remittance Advice (ERA)! The PC Print software gives providers the following abilities:

• Easy navigation and viewing of the ERA using your personal computer;
• Print the ERA in the Standard Paper Remittance (SPR) format;
• Search capability that allows providers the ability to find claims information easily;
• Print and export reports about ERAs including denied, adjusted and deductible applied claims;
• Easy-to-use method to archive, restore, and delete imported ERAs

Providers can view and print as many or as few claims as needed. This will be especially helpful when you need to print only one claim from the remittance advice when forwarding the claim to a secondary payer. This FREE software can save you time resolving Medicare claim issues. Take advantage of the PC Print features unavailable with the SPR. PC Print is only compatible with officially supported Microsoft Windows Operating Systems.

EDI List Serve:

An EDI List Serve is available. This is the fastest way to stay informed of EDI news, changes and updates. Once subscribed, you will receive e-mails containing the latest information.

To subscribe to the EDI List Serve, click here.

Connectivity Alternatives/Network Service Vendors:

AdminaStar Federal offers the network service vendors, IVANS, Nebo Systems and VisionShare, to provide an alternative method of communication to EDI Services. These vendors offer services and benefits that include connection to AdminaStar Federal for submission and receipt of HIPAA transactions and access to the the Direct Data Entry (DDE), Professional Provider Telecommunication Network (PPTN) and Claim Status Inquiry (CSI). To receive additional information on the services provided from these network service vendors and pricing structures, use the contact information provided below.

Support:

Our EDI Helpdesk consists of highly trained experts in the field of EDI. They are available to assist providers with any electronic needs.

1-877-ASF-4EDI (1-877-273-4334)
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Times of operation are as follows:

8:00 a.m. - 11:30 a.m. and 12:00 p.m. - 4:00 p.m. (EST) Monday, Tuesday, Wednesday and Friday
8:30 a.m. - 11:30 a.m. and 12:00 p.m. - 4:00 p.m. (EST) Thursday

The EDI Helpdesk can be contacted via email at ASF.EDI.A@anthem.com.