This is a segment of the Invoice Data Entry Screen
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Invoice Screen
Alabama State-dependent Codes/Fields required by Medicare/Medicaid
SPECIAL ALABAMA STATE-DEPENDENT FIELDS IN THE INVOICE DATA ENTRY SCREEN
Alabama Medicare Secondary Modifiers - The Medicare Information code is a secondary modifier filed with NSF electronic claims.
This is a segment of the Invoice Data Entry Screen
When the cursor is at the Medicare Information code field, the codes are displayed at the bottom of the screen in the prompt line, plus pressing function key F1 will display both codes and descriptions for selection as shown below
Secondary Modifier Help Screen
ENTERING THE PRIMARY AND SECONDARY PAYERS IN THE INVOICE DATA ENTRY
SCREEN
The system uses numbers 1-9 to designate the different type payers, these
numbers we call paycodes. With time, knowing these paycodes will become second
nature. However, at first, you may either need to write these down for reference, or
use the help screen. When your cursor is at one of these paycode fields, pressing
function key F1 will display the following:
Medicare
is the Primary Payer--Window in Invoice Screen
In the primary paycode window, when 1 is entered in the Pri Pay Code field, the top half
of this window is displayed.
Reason for Transport --
Either enter none, 1, 2 characters per the prompt line at the bottom of the screen, or
press function key F1 for the help screen
Reason For Transport Help Screen
The following are listed in the order of importance/severity: U, H, E, P/B, S, N.
Note that B is more important than S. always use B when possible, but be prepared to
specifically say why in the secondary diagnosis narrative. Leaving both characters blank
is acceptable, but not advisable.
Accept Assignment -- Participating Providers Must Accept Assignment. This means at least two things: (1) You must accept the Medicare Allowed Amount on the EOB as the total amount you can collect when there is a non-zero allowed amount. Medicare will pay 80% (if there is no deductible), and you are required to attempt to collect 20% from either secondary coverage (coinsurance) or from the patient (copay). (2) Payment comes directly to the ambulance company rather than to the patient.
Filed -- There are two dates, the first is for the first filing, and the second is the refile date.
Paid/Rej(ected) -- Automatically set when posting payments, but can be manually changed here.
Medicare No -- HIC number copied from the patient screen.
Transported To/For--A Prompt line will be displayed for choices, and pressing the function key F1 will display this help screen:
Transported To/For Help Screen
File By Modem - defaulted per the flag in the company screen parameter flags. If Y is in this default, then this will be defaulted here. However, there may be certain claims that need to be filed paper, even though electronic claims being used. If N appears here, this claim will not be extracted for electronic transmission.
Medicare
is the Secondary Payer--Window in Invoice Screen
(see Medicare Primary above for screen parameters)
Medicaid
is the Primary Payer
Window in Invoice Screen
In the primary paycode window, when 2 is entered in the Pri Pay Code field, the top half of this window is displayed.
AppNo (Prior Approval Number)-- Required for non-emergency transports only
Medicaid--Medicaid number extracted from the patient file
Filed--two date fields, the first is first filing date, second field is the refile date
Paid/Rej--Automatically set to either P or R from posting payments, but can be overwritten here
Physician's Statement On File-Y(es) or N(o)
Date Verified--only for your own internal use for the date you verified Medicaid eligibility
Modifier - The prompt line (shown) are your choices. Note that a single round trip filed as one claim counts as one trip
Medicaid
is the Secondary Payer
When Medicaid is the secondary payer, generally they will do what ever the primary does,
using the same charges, HCPCS codes, diagnoses, etc. The invoice window for Medicaid
secondary is the same as Medicaid primary as shown above-click here