4. Paper HCFAs: Details of the hcfa Program
Hopefully most of your claims are submitted electronically. Some claims must still be printed on paper, however. The procedure above provides the basics. This section describes additional details and options in the hcfa program.
4.1. What Claims Require a Paper HCFA 1500 Form?
Secondary Claims require a copy of the EOB from the primary payor, and therefore can not be submitted electronically in most cases. You will need to print out the claim and staple a copy of the EOB to it.
Charges posted to non-"Real" providers. This generally includes the "Office" provider and Nurse Practitioners. Speak with PCC Support for help configuring which providers are valid for electronic submission. You should inform PCC Support whenever you add a new provider so they can be configured properly for claim submission.
Claims containing "E" diagnosis codes. These codes indicate an emergency visit. Since they generally require additional paperwork, they are automatically sent to a paper batch.
4.2. Generating HCFA 1500 Forms
You can print single paper claims from chuck, pip, or oops. Run the hcfa program to print an entire batch of paper claims.
 | Do you need to recreate an entire batch of old, previously submitted claims? Read the Resubmit HCFA Forms (maketags) manual. |
When you run hcfa, you are first presented with a list of batches:
On this screen, you can review the number of waiting claims, the date the batch was last printed, and the name of each batch. As described in the procedure above, you can select any batch and press Enter to begin printing.
Is that the Number of Claims that Should Print? The number of claims in this list does not represent the exact number of claims waiting to be printed. It represents the number of tags waiting to be processed. When you select a batch and press Enter, Partner processes the claims and may discover that some of the claims no longer exist. The charges may have been printed and submitted separately, they may have been deleted, or you may have corrected and rebatched charge information (creating an uneeded duplicate tag).
What are the "Z_ECS" Lines for? The hcfa program can generate paper claims for any set of tags waiting to be submitted. You can even print out claims that are supposed to be submitted electronically by selecting one of the "Z_ECS" lines listed in hcfa. This is not recommended and should only be done in an emergency (i.e., your internet connection and modem are down and a timely filing limit is approaching). Even then, it is probably preferable to run oops and print needed claims one at a time.
4.3. Features and Options While Printing Claims
As hcfa runs, you will see a number of messages on the screen as the claims are generated:
Claims are Prepared and Listed. hcfa will process all of the tags waiting in the batch you chose. You will see a message listing the claims:
I am getting ready to process the claims. I am now processing the claims. Flinstone, Pebbles 07/01/04 $ 50.00 B MEDICAID Flinstone, Bam Bam 04/02/04 $ 50.00 C MEDICAID Canning, John 03/03/04 $ 26.00 C MEDICAID I am done processing the claims, and am ready to print them.Print a Test HCFA 1500? Next, hcfa gives you the option of printing a sample form to make sure your paper is properly aligned. This is especially important if you print HCFA 1500 forms on an Okidata or other pin-fed printer.
I can print a test form for you, so that you can check the alignment of the paper. Do you want a test MEDICAID form printed (yes or no)? Yes Do you want another test MEDICAID printed (yes or no):You can print as many test forms as you need.
Final Confirmation to Print. The hcfa program double-checks that you are ready to print your claims. You can type "No" and then follow the prompts to quit, or type "Yes" to print out your claims.
I am all ready to print these MEDICAID forms. Are you? If you say yes, I will print them, otherwise I won't:Confirm Successful Printing. In case there was an error while printing, hcfa asks if the claims printed successfully. You should wait until the claims finish printing and review them before answering "Yes" to this question.
Here Goes... I am printing the forms. Are you satisfied with the MEDICAID forms printed? If you are, I shall clear out the queue for this type of form. If you are not, I will give you another chance to print them. Are you satisfied with the MEDICAID forms?Print a Log of HCFA Forms. A log of all the HCFAs generated will automatically print out when you quit the HCFA program.
Reprinting Batches. Partner stores a record of the last printing of each HCFA Batch so you can easily reprint it. At the bottom of the list of batches, you will find options to reprint the last run of each batch:
If you need just a log of the last batch printed, but do not need to print the batch itself, simply select the "Reprint..." option for the needed log, and then answer "No" to the subsequent questions (do not print any claims). Upon quitting the hcfa program, the log will reprint.