MediSoft Electronic Media Claims

Lightning-Fast Insurance Claims!

Many health care billing programs can send insurance claims with a modem. MediSoft has many options for electronic claims -- from clearing house claims for easy, universal access, to direct electronic claims modules for selected insurance carriers that eliminate per-claim fees. All MediSoft software includes clearing house electronic claims software at no extra charge.

Electronic Claims are Faster than Paper

Electronic claims significantly reduce the amount of time a practice waits to be paid for their services. On average, electronic claims are paid in half the time of paper claims. Electronic claims improve payment speed in two ways: First, the mail system is avoided. An electronic claim can arrive at a carrier's office within 24 hours and be ready to be paid by their computer. Contrast this with the time it takes for the post office to deliver the mail and data entry staff at the carrier's office to enter the claim information! Second, insurance carriers give priority processing to electronic claims. Medicare processors cut two weeks off their payment time to give providers the incentive they need to send claims electronically!

Which Claims Can Be Sent Electronically?

MediSoft Direct Electronic Claims software is offered for selected insurance carriers. Medicare, Medicaid and Blue Cross/Blue Shield accept claims directly from providers and billing services in most areas. Few other carriers offer this option, making MediSoft clearing house claims the perfect partner with direct claims modules in most practices.

Electronic Claims are as Easy as Paper

Billing data is entered into MediSoft, then is used to print paper claims or submit claims electronically. No additional data entry is required -- Just select the Electronic Claims menu option!

Free Electronic Claims Software Isn't Free

Carrier-supplied software works differently than MediSoft, requiring extra time to learn and use. Claim information sometimes must be entered a second time to use carrier-supplied software. MediSoft Direct Claims modules work inside MediSoft, using the same familiar menu structure and commands.

Carrier Tested and Approved
Works Inside MediSoft
No Data Reentry
Usually No Per-Claim Fee

Clearing House Claims

NDC Health EDI Services

MediSoft recommends clearinghouse services of National Data Corporation (NDC).

NDC Health EDI offers electronic claim submission services for Medicare, Medicaid, Blue Cross/Blue Shield and commercial carriers in most states. NDC's offices are located in Atlanta, Georgia, but all claim submission and support calls are made on toll-free phone lines. NDC submission software is included with all MediSoft and PractiSoft products.

When you use NDC electronic claims services you get these advantages:

All claims for Medicare, Medicaid, Blue Cross/Blue Shield and commercial carriers are sent to one location with one telephone call.
Claims are immediately edited for valid content. Claims are checked for missing information, valid procedure and diagnosis codes, and other information specific to the carrier for which the claim is intended
A report is returned in the same telephone call detailing which claims were accepted and forwarded and which claims were rejected, along with information on how to correct the claims.
All carriers' claims may be sent to NDC. If an insurance carrier cannot accept claims electronically, NDC will laser print and mail a paper claim form.
NDC electronic claim submission software is included free with every MediSoft program - There's nothing more to buy
Beginning users find that NDC's editing services make electronic claim submission easier. Users learn from NDC's edit reports, helping to avoid future claim rejections.

Good news for billing services! NDC has recently changed the way you pay for clearinghouse signup. Instead of the old $300 support fee plus $50 per provider, billing services pay the same setup fee as a healthcare practice - just $125 per provider tax ID number. And NDC submission services are affordable -- Each claim costs just thirty nine cents.

If you have any questions please email us:
EMC@medical-billing-software.net

Direct Electronic Claims Modules

When a practice sees a concentration of patients who are insured by a particular insurance carrier, direct insurance claims can save the per-claim fee common with claims clearing houses.

Currently Available Direct Claims Modules

Following are currently available MediSoft Direct Claims modules. Direct electronic claims modules are available for MediSoft for DOS and MediSoft for Windows. Availability of ERA Auto Pay, a MediSoft product for automatically applying payments based on Medicare's electronic remittance advice, is noted in the ERA column. Contact your independent MediSoft dealer or MediSoft for details.

State	Code	Carrier	Claims Accepted	ERA
AK	AEMA	Aetna (submits to BC/BS of ND)	Medicare Part B	Y
AK	WMSC	Premera Blue Cross	Medicare Part B, Blue Cross and Blue Shield, Commercial
AR	ARMB	Blue Cross and Blue Shield of Arkansas	Medicare Part B, Blue Cross and Blue Shield
AZ	AEMA	Aetna (submits to BC/BS of ND)	Medicare Part B	Y
AZ	APN1	Arizona All Payor Network	Medicare Part B, Blue Cross and Blue Shield, Commercial
CA	CATA	Transamerica Occidental Life and Casualty	Medicare Part B for Southern California	Y
CA	CABS	National Heritage Insurance Company	Medicare Part B for Northern California	Y
CA	CAMC	MediCal	MediCal
CO	NDMB	Blue Cross and Blue Shield of North Dakota	Medicare Part B	Y
CT	TRMB	United Health Care	Medicare Part B	Y
DE	MDTB	Maryland Trailblazers (DOS only)	Medicare Part B
DE	DETBW	Delaware Trailblazers (Windows only)	Medicare Part B	Y
DC	MDTB	Maryland Trailblazers	Medicare Part B	Y
DC	MHIN	Maryland Health Information Network	Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
FL	FLMB	Blue Cross and Blue Shield of Florida	Medicare Part B, Blue Cross and Blue Shield, Health Options, Champus, Commercial	Y
GA	AEMA	Aetna (submits to BC/BS of AR)	Medicare Part B
HI	AEMA	Aetna (submits to BC/BS of ND)	Medicare Part B
HI	HMSA	Hawaii Medical Service Assoc.	HMSA, Quest, Medicaid
IA	INET	Iowa INET	Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
IL	ILBB	Blue Cross and Blue Shield of Illinois	Medicare Part B, Blue Cross and Blue Shield, Medicaid, Champus, Commercial	Y
IL	WPSI	Wisconsin Paperless System	Medicare Part B	Y
IN	AIM1	Indiana Administar	Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
KY	KYMB	Administar Federal of Kentucky	Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
LA	ARMB	Blue Cross and Blue Shield of Arkansas	Medicare Part B
MA	NHIC	National Heritage Insurance Company	Medicare Part B	Y
MD	MHIN	Maryland Health Information Network	Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
MD	MDTB	Maryland Trailblazers	Medicare Part B	Y
ME	NHIC	National Heritage Insurance Company	Medicare Part B	Y
MI	WPSI	Wisconsin Paperless System	Medicare Part B	Y
MN	TRMB	United Health Care	Medicare Part B	Y
MO	ARMB	Blue Cross and Blue Shield of Arkansas	Medicare Part B for Eastern Montana
MS	TRMB	United Health Care	Medicare Part B	Y
ND	NDMB	Blue Cross and Blue Shield of North Dakota	Medicare Part B, Blue Cross and Blue Shield
NH	NHIC	National Heritage Insurance Company	Medicare Part B	Y
NJ	PABS	Pennsylvania Electronic Medicare Service	Medicare Part B, Blue Cross and Blue Shield, Commercial	Y
NM	AEMA	Aetna (submits to BC/BS of AR)	Medicare Part B	Y
NM	ARMB	Blue Cross and Blue Shield of Arkansas	Medicare Part B
NV	AEMA	Aetna (submits to BC/BS of ND)	Medicare Part B	Y
NY	GHI1	Group Health Incorporated	Commercial
NY	NYGH	Group Health Incorporated	Medicare Part B for Queens	Y
NY	NYUM	New York Upstate Medicare Division	Medicare Part B for Upstate Area	Y
NY	NYEB	Empire Blue Cross and Blue Shield	Medicare Part B, Blue Cross and Blue Shield, Commercial	Y
OH	OHMB	Nationwide Mutual Insurance	Medicare Part B	Y
OH	AIM1	Indiana Administar	Blue Cross and Blue Shield, Commercial
OK	AEMA	Aetna (submits to BC/BS of AR)	Medicare Part B	Y
OK	ARMB	Blue Cross and Blue Shield of Arkansas	Medicare Part B
OR	AEMA	Aetna (submits to BC/BS of ND)	Medicare Part B	Y
PA	PABS	Pennsylvania Electronic Medicare Service	Medicare Part B, Blue Cross and Blue Shield, Commercial	Y
SD	NDMB	Blue Cross and Blue Shield of North Dakota	Medicare Part B	Y
TX	TXBB	Texas Health Information Network	Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial	Y
VA	TRMB	United Health Care	Medicare Part B	Y
VT	NHIC	National Heritage Insurance Company	Medicare Part B	Y
WA	AEMA	Aetna (submits to BC/BS of ND)	Medicare Part B	Y
WA	NDEX	Network Data Express	Medicare Part B, Blue Cross and Blue Shield, Medicaid, Department of Labor and Industries, Commercial
WA	WMSC	Premera Blue Cross	Medicare Part B, Blue Cross and Blue Shield, Medicaid, Department of Labor and Industries, Commercial
WI	WPSI	Wisconsin Paperless System	Medicare Part B	Y
WV	OHMB	Nationwide Mutual Insurance	Medicare Part B	Y
WY	NDMB	Blue Cross and Blue Shield of North Dakota	Medicare Part B, Blue Cross and Blue Shield	Y

Medisoft ECD Modules are products of NDC HEalth