Hopefully your practice can submit almost all of your claims electronically. Some claims must still be printed on paper, however.
Read the Submit Claims article to review the basic steps of submitting both electronic and paper claims.
This reference article will help you better understand your paper claims, and provides details and options available in the
What Claims Require a Paper HCFA 1500 Form?
Why would you need to print a paper claim?
Secondary Claims That Require EOB: In many cases, a secondary claim requires a copy of the EOB from the primary payer, and therefore can not be submitted electronically. You will need to print out the claim and staple a copy of the EOB to it.
Unusual Rendering Provider Situations: When a charge is posted to a non-provider, such as the “Office” provider or a nurse, you may encounter a situation where a claim can not be submitted electronically. You should speak with PCC Support for help configuring which providers are valid for electronic submission. Whenever you add a new provider, inform PCC Support so they can be configured properly for claim submission.
Emergency Visits (E Codes): When a claim is a result of an emergency visit, it may contain “E” diagnoses codes. Since these visits generally require additional paperwork, they are automatically sent to a paper batch.
Generate HCFA 1500 Forms
You can print single paper claims from many screens in Partner, including
oops. Run the
hcfa program when you need to print an entire batch of paper claims.
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 re-batched charge information (creating an unneeded 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 the claims you need one at a time.
Review Features and Options As You Process Paper Claims
hcfa runs, you will see a number of messages on the screen as the claims are generated. Review the steps below to learn more about each step.
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?
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
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.
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.