Support Handbook

SolAce EMC Support Handbook

If you experience any issues viewing some of the contents in this handbook, please contact our Support Team at 602-439-2525.

Installation Quick Tips

This section covers how to install and access the various editions of the SolAce EMC product.

SolAce EMC Desktop Installation

Installing SolAce on a Microsoft Windows™ computer


Installing Desktop V3 Edition from the Internet
Download the latest SolAce EMC Desktop Edition installer and let it run to install the software on your workstation.

To continue, click the "Install" button to install to the default directory on your hard drive (C:\SolAce3). You may choose a different drive and directory by typing the location or by clicking on the browse button at the right side of the field. As of version 3, SolAce may not be installed to a network drive.

The setup program will proceed to install SolAce to your computer. When the install is complete, the installer's window will automatically close.

To start SolAce EMC V3, find the SolAce EMC icon on your desktop, or in the SolAce EMC menu in your Start / Programs menu and double click on the icon.



Installing Desktop V3 Edition from a CD-ROM
If you are using the single-user Desktop Edition, place the SolAce EMC CD-ROM into the CD-ROM drive of your computer. The installation process should start automatically.

To continue, click the "Install" button to install to the default directory on your hard drive (C:\SolAce3). You may choose a different drive and directory by typing the location or by clicking on the browse button at the right side of the field. As of version 3, SolAce may not be installed to a network drive.

If your CD-ROM drive is not set to automatically run when a CD-ROM is inserted, click on "Start", then click "Run", then type "d:setup", where d: is your CD-ROM's drive letter.

The setup program will proceed to install SolAce to your computer. When the install is complete, the installer's window will automatically close.

To start SolAce EMC V3, find the SolAce EMC icon on your desktop, or in the SolAce EMC menu in your Start / Programs menu and double click on the icon.

SolAce EMC Hosted Access

Accessing SolAce EMC Hosted Edition

Launch your internet browser such as Internet Explorer or Mozilla Firefox and type the following url into your address bar: http://app.solace-emc.com

When the web page opens, click on Start SolAce at the top of the screen and click on the SolAce EMC icon on the left side of the following page.

If your computer does not have Java™ already installed then your web browser will attempt to install it automatically. If that fails for any reason you can visit the official Java web site to install the Java Runtime Environment (JRE). Click the Start SolAce icon at the top of the web page after installing the JRE and you should be rewarded with a larger SolAce icon that will successfully start the application.

SolAce EMC Multi-User Installation

Starting SolAce EMC from your Office Network

If you are using the Multi-User Enterprise Edition of SolAce that's installed in one of your servers, you must open a web browser and enter your server's name or ip address to access the SolAce start page. You may need to consult with your IT department to find out which server is running the SolAce EMC software.

Once you have accessed the web page, click the Start SolAce icon on the top of the page and then click the SolAce EMC icon on the left side of the following page to get started. During the initial start an icon will be created on your desktop for subsequent use of the program. Make sure you select "yes and always" to trust all security certificates pertaining to the SolAce EMC software.

SolAce Setup Screens

Setup/Security
This is where you can add or delete a user, change your inactivity timeout and assign access levels for SolAce users.

NOTE: Giving a user System Admin rights will enable that user to do all functions available in SolAce and view multiple site information if there is more than one site for the client. It is best to just use the “Allow All Site Access” or “Only Allow Access To” when assigning access levels.

Setup/User Options
Here, you can inactivate the “Side Bar/Top Bar” that contains the screen shortcuts. You may also set the “Print file” and “NSF file” paths here.

Setup/Mailboxes
Here, you will find a listing of all your mailboxes that are currently setup in SolAce. You may double click a mailbox in this screen to edit a mailbox’s properties.

Things to Remember:

  • In the Mailbox properties tabs, make sure no punctuations such as periods, hyphens, commas, etc… are used.
  • The transmission mode for Test and Production can also be found here in the Mailbox tab.
  • Remember that the submitter ID, username, and password boxes in the “Connection” tab are case sensitive.
  • This is also where the Next Control number mentioned earlier can be changed.
  • The Weight of a mailbox can also be adjusted here to prioritize a mailbox over another.
  • In the Providers tab, remember to mark the selected providers who will be submitting for the selected mailbox. Or leave them all unchecked to allow all providers to use the mailbox.

NOTE: If the provider has multiple IDs for one receiver (mailbox) the appropriate ID needs to be selected.

Setup/Providers

Things to Remember:

  • The provider code box is internal to SolAce. There is no need to change this.
  • If the entry being made is for an Organization, make sure that the Last, First name boxes are not filled. If the entry is for Solo Practice, make sure the Organization box is not filled.
  • For every Group Practice set up, there should be Group Providers set up as its members.
  • For the Group Providers, make sure that the correct Group practice is selected in the “Group” box.
  • PIN Overrides are necessary if the set PIN number on the print file is different from the PIN number the payer has issued. In this case we can ask SolAce to override the PIN generated in the print file and replace it with the PIN created in the PIN Override section for the specific payer.
  • If the tax ID entered is not the provider’s SSN then EIN/TIN should be selected for “Type”.
  • The Taxonomy Code is not the Tax ID. It is a code that identifies the provider’s line of specialty.

Setup/Maps
This is where you will choose the maps that you would like to use for your claims. A check mark under the “Active” column in the Form Mapper screen will indicate which maps are currently being used. Maps tell SolAce where to place the data from your print file in a selected form. (i.e. Medicare CMS-1500, UB-04 form, etc.) To view a map and edit it, double click it to open into the Map Editor screen.

NOTE: If your print file’s path is properly setup in Setup/Options the map should open automatically reflecting your print file’s data in the background. If your print file’s path is not properly set up, you may be prompted to locate your print file.

Things to Remember:

  • SolAce is defaulted to show only the enabled fields once the map is opened. To see all available fields for use, choose All Fields in the “Filter” section at the bottom right corner of the Map Editor screen.
  • When going through the map, it is best to go down the fields list on the right and see where the corresponding box is located in the left pane.
  • A check mark next to the fields on the list means that the field is active.
  • In order for a map to open, it requires data in the background. SolAce is set to use the last print file you generated as the map’s background. Therefore, if you would like to map a commercial map, you should make sure your current print file contains commercial claims to help make your mapping experience easier.
  • To change the width of a field box, hold down the Shift key and use your keyboard arrows to make the box longer or shorter.
  • To move a field box, hold down the Ctrl key and use the arrows on your keyboard to move the box around your form.
  • To change a box height, double click it and change its “height” to 1 if you want it to only cover 1 line of data.
  • Make sure there are no boxes overlapping each other.
  • Note that only the “Yes” and “Female” indicators should have a box around it. (SolAce knows that if “Yes” is not checked then the answer is “No”.)
  • If all the fields seem to be 1 or 2 spaces off, rather than adjusting each box one by one, you can use the “Adjust All” function at the top of the page and adjust all of the field boxes at the same time.
  • Make sure that “Insured ID page 2” box 1a, is placed over the patient's ID on page 2. This will tell SolAce where page 2 of your batch starts.
  • To browse through the claims in your batch left click on one of the field names from the fields list to highlight a field and hold down the Ctrl button on your keyboard and press the Page Down or Page Up key on your keyboard. The red numbers on the top left side of the screen will indicate which claim you are viewing on your screen.

Setup/Patients
If you are entering claims directly into SolAce, you may pre-enter your patient’s basic information here so that the next time the patient is seen, his/her information will already be pre-entered.

Things to Remember:

  • When creating patient records, make sure the following tabs are filled in:
  • Demographics
  • Provider
  • Insurance
  • If you are directly entering patient information in the Claim Editor/CMS-1500 screen, you can save the patient’s record into the Patient File screen. To do this, go into the Claim Editor/Patient tab and click the “Sync to Patient File” button. Unless that button is pushed, all direct entries made in the Claim Editor screen will not be saved into a patient file.

NOTE: The “Sync to Patient File” button will not populate patient information into your forms. It simply saves the data you have entered about your patient into a patient file so that you may retrieve that patient’s information for future use.

Setup/Addresses
You may use the Address book to enter information for Referring Physicians or other contacts so that their information will always be ready for your use via a drop down list on the Claim Editor screen when you are working on your claims. Make sure to select the correct Address Type fom the drop-down menu at the top right. For example, Physician is the correct Address Type for a Referring Provider.

Setup/Bill Codes
You may pre-enter commonly used bill codes here so that service line information can be populated from a single key-stroke when you are processing claims. This will save you time from having to enter these codes manually into claims every time. A custom bill code can also be created here to combine multiple bill codes that are commonly necessary for certain exams.

The SolAce User Guide
To learn more about the SolAce application, you may access the SolAce User Guide at anytime by pressing the F1 key on your keyboard while you are working in SolAce. You may also click on the Help menu and then select User Guide.

Getting Started Check List

Installed, Are you ready to send?

This document assumes you have already installed SolAce EMC. If you are using SolAce EMC as a claims entry product only, please skip any references to print files or mapping in this document.

Sign in to SolAce using the default username of admin and password of admin, unless you were assigned specific login information. Then visit the screens referenced below to check your setup.

System Options
Go to Setup/User Options and check that you have a print file path specified. If you will be importing claims it saves some time to put your print file path here, otherwise you will have to choose it each time you go to import or map your print file.

Mailboxes
Go to Setup/Mailboxes and confirm that you have at least one mailbox on the list. You should have one mailbox for every electronic receiver that you want to send electronic claims to. (For example: Palmetto GBA for Railroad Medicare claims and/or National Government Services for Durable Medical Equipment claims.)

Providers
Go to Setup/Providers and check that you have all of your "billing" entities on the list. Add any that are missing. (Group Practice, Group Provider, Solo Practice Provider, or Organization)

Payers
Go to Setup/Payers and check which payers are associated to an electronic mailbox under the "mailbox" column. Only payers linked to an electronic mailbox will be available for your use in electronic billing. All others will only be useful for printing paper claims out of SolAce.

Mapping
If you will be importing claims from a print image or comma-separated (CSV) file go to Setup/Maps and double-click on your active map. Make sure the boxes are linked to the data on the mapping screen. Use the Ctrl+PgDn and Ctrl+PgUp keys to page through your print file and see if it looks consistent all the way down.

Critical fields to have turned on include PAYER-NAME, INSURED-ID, INSURED-ID2 (or INSURED-ID-PAGE2), SVC-OFFSET, and PROVIDER-ID.

Test your map by importing your claims to see if it was able to pick up all of the data from your file.

Transmission
If you are on the online hosted version of SolAce you should not have to worry about this, the system operators should be taking care of this aspect for you.

If you transmit to modem-based destinations, visit Setup/User Options and click on the Modem tab. Press the Test button at the top to make sure SolAce is able to read your modem and confirm that your dialing properties for making calls are entered properly in the boxes below.

If you transmit to Internet-based destinations you just need to be sure you have Internet connectivity on the workstation where you use SolAce.

If you transmit to dial-up networking destinations you will have to have a dial-up networking (or PPP connection on Mac/Linux) setup in whatever manner your operating system requires.

Using and Troubleshooting

Please visit the links below to find Troubleshooting Guides for the SolAce EMC screens.

Errors while importing

Importing Claims

To begin importing your claims click on File/Import and choose your print file’s file type (i.e. print image: txt-csv, nsf, ubf, etc…).

  • Usually the location of your file is preset in the “Print file” box located in Setup/User Options. If it’s not set up, you will be prompted to locate the file. Once the proper print file is selected its path should appear in the “Import file” box.
  • After choosing your import file you need to make sure that the appropriate map for the claims being imported is chosen in the “Form Map” box.
    NOTE: This applies to print image files and .csv files only.

Possible Problems and Causes:

Problem
Error Message: “The import file cannot be found

Causes

  1. The print file location is not setup in the Setup/User Options “Print file” box and can’t be found.
  2. The print file location set in the Setup/User Options “Print file” box is incorrect because the print file is currently exporting to a different location.

Solution
In this case you will need to contact your Practice Management Tech and ask where your print file is being stored. Once it is found, you will need to save its file path into the Setup/User Options “Printfile” box.

Problem
Error Message: “ Total charges is invalid”, “ The input file ended unexpectedly”, or “Your input file ended prematurely while extracting field..."

Causes
If you experience any of the errors above, please check if any of the following apply:

  1. The wrong map is selected in the “Form Map” box.
  2. The print file being imported is empty.

Solution

  1. If you have selected the wrong Form Map, please click on the drop down arrow in the “Form Map” box and select the correct Map and try your import again.
  2. If the error message states that your file is empty you should open the actual file that you are trying to import in Notepad and confirm if it contains any data. If it doesn’t, please contact your practice management tech and let them know that your claims are not exporting to the print file properly.

Problem
Error Message: “This batch of records is a duplicate…”

Causes
The batch has been previously imported.

Solution
If you receive this error, please check the File/Manager screen to see if this batch has already been imported. If you would like to continue re-importing the batch, delete the one previously imported in File/Manager and try your import again.

Warnings after Import

Warnings after Import

After clicking “Continue” at the Import screen, if SolAce found problems in your batch, you will be automatically redirected to the Claim Editor screen so that you may fix your errors. Common problems experienced at this stage are as follows:

  • If SolAce does not recognize the payer ID that your practice management system generated in your print file, a pop-up box asking you to set up an alias for that payer will appear. At this time you can select the appropriate payer from SolAce’s Payer List and create an alias for it so that every time it reads the print file and sees the unrecognizable payer name it will know which payer ID to link it to in the SolAce payer list.
  • If SolAce does not recognize the provider ID generated in your print file, you will be prompted to select the appropriate provider from the SolAce Provider List. To prevent this from happening again, you should check the provider ID entered in your Practice Management System and confirm if it matches the Provider ID you entered in SolAce for that specific provider. If a Pin-Override is necessary, one can be created in the Setup/Providers/Provider File/PINOverrides section.

Possible Problems and Causes:

Problem
Warning Message:” Solace does not recognize the payer name…”

Cause
The Payer name entered in the print file and SolAce's payer list does not match.

Solution
Create an alias for the payer by selecting the appropriate payer from SolAce’s Payer List. This will let SolAce know which payer to send your claims to when it reads the payer name printed in your print file.

NOTE: Users tend to click “Ok” when prompted to create an alias and choose the first payer on the payer list instead of actually searching for the proper payer. This leads into claims going into the wrong payer and mailbox. To check if the wrong payer was selected during a previous setup, you may type the payer name used in the print file into the Payer List’s “Find” box and SolAce will search for the payer the alias was created in. Once the payer is found you can double click on it to see its properties and remove the name placed in the “Aliases” box and place it under the correct payer ID’s “Aliases” box.

Problem
Warning Message: “Billing Provider or Group ID must match to an entry…”

Cause
The Provider ID entered in the print file and SolAce’s Setup/Provider/Provider File does not match.

Solution

  1. Double check your Provider ID and NPI entries in your practice management system and SolAce’s Setup/Providers/Provider File screen and confirm that they are correct.
  2. Create a PIN Override for the provider ID in the Setup/Providers/Provider File/PIN Overrides section.

NOTE on PIN Overrides: PIN Overrides are necessary in cases where a payer requires a different PIN when billing electronically than what is normally printed on your claim form. Or, your practice management system may only support one PIN for paper claims, and you need SolAce to handle multiple PINs for your electronic claims.

Working in the File/Manager Screen

File Manager

In the File/Manager screen, you can select a batch that you would like to review and open into the Batch Editor screen. Once you are in the Batch Editor screen you can select individual claims that have errors that need corrections.

Important things to know about the File/Manager columns:

File – Filenames are created based on the date and a number indicating the order in which it was imported on that date: [year][month][day] - ##. A file named 20051111-03 was the third file imported on November 11, 2005.

If the Queues assignment feature is used, the Queue name will appear before the File name.

Label – This is a descriptive title that can be assigned to a file at import or a later time in the file manager by highlighting a batch and clicking on Label at the bottom. This is not a necessity, but can be a great help in identifying your batches when tracking problems with claims. You may also assign Queues and Colors to your batches using this button.

Transmit Date – This date is helpful to note when tracking a claim through the message center, as file naming in the message center for this column is similar to file naming in the file manager.

Status – The status field reflects the stage of the electronic claim. (i.e. ready to send, outbound, sent, etc…)

NOTE: It is extremely important to note that although the status for a batch in the file manager may be “Accepted,” this only means that it has been accepted by a payer’s computer system, and not by the actual claims processing department. The status “Accepted” does not mean that a payment is on the way.

Important things to know about the File/Manager tabs:

Professional Claims – All your professional claim batches will be imported to this tab.

Institutional Claims – All your institutional claim batches will be imported to this tab.

Remittance Advice – All your electronic EOBs will be displayed in this tab.

  • Once you double click into an EOB you may click on the Report button at the top of the screen to print out your entire EOB or you may choose a patient name and click Print Selected at the bottom of the screen to print an EOB for a specific patient.

Important things to know about the File Manager buttons:

New – This button will enable you to start a new batch

Open – This button will enable you to open a batch

Delete/Archive – This button will move your selected batch into the Archive page.

NOTE: Only files that have been transmitted can be “Archived”, all other files that have not been transmitted will be deleted out of SolAce if this button is pushed.

Filter - This area is used to select a queue that you have created under the Setup/Queues screen and to expose the "View archived file" check box which takes you to the "Archives" screen.

Working in the Batch Editor Screen

Batch Editor
To get to the Batch Editor screen, go to File/Manager and double click on a batch that you would like to review. Double clicking your selected batch will automatically open the Batch Editor screen.

Important items to review in Batch Editor:

Status Button– If a batch needs to be edited and resent for any reason (i.e., it was previously rejected and needs a change), just click on the button that says Status at the bottom of the screen or the ellipsis button to the right of the status field near the top, and click on the drop down menu on the “View/Change Status” box that appears and change it to “Resend” and click ok.

Report Button– The report button at the top right will give you the option to print a summary report or a detailed report for your batch.

Transmit Button– This button will enable you to send out claims in your batch that are ready to send even though you still have a few with warnings that you need to work on. Clicking this button will separate the claims with the status of “ready to send” or “resend” to another batch that is clear to send.

Preview EDI Button - We have conveniently added this button so that you can preview what your EDI file will look like once your batch is in the "Ready to send" status.

Print Button - To print your claim onto a CMS or UB form that you have purchased (alignment charges may apply), use the "Print Preview" feature. To print the claim with an image of the CMS or UB form onto a blank piece of paper with colored ink, use the "Save as PDF Forms" feature. Remember to select one or more claim(s) prior to pressing the "Print" button.

Status Column - This column will show you the specific claim's status. If the claim's file has been sent, it will even show you the outbound file control number that was assigned to the outbound file that was sent to your payer. This number is often referenced in the inbound files that you receive in your inbox from your receivers.

Mailbox Column – It is best to double check this column to make sure that your claims are going into the correct mailbox before you generate your EDI outbound file.

Working in the Claim Editor Screen

Claim Editor

To get to the Claim Editor screen, go to File/Manager, double click on a batch to open into the Batch Editor screen and then double click on a claim to open into the Claim Editor screen.

Here, you can go through each claim and correct any errors that each claim has. The errors are represented by warnings at the bottom of the screens.

Warnings in Claim Editor:

Warnings – To correct your warnings, double click on a warning at the bottom of the claim editor screen. Once you double click on a warning SolAce will move your cursor to the appropriate tab that needs correction and it will highlight the specific field in the claim that needs to be corrected. Often, the fields will either have a drop down list or a magnifying glass next to it that will take you to a list of options to choose from to correct the error/warning.

Navigation Arrows:
To review each claim record within your batch, use the navigation arrows at the top of the screen.

Important things to know about the Claim Editor tabs:

Tabs – Each tab running across the top of the page after the CMS-1500 tab relates directly to a box in the CMS-1500 tab. Therefore, any information entered in the CMS-1500 fields will also be automatically populated into its related detail tab in the Claim Editor screen.

All Fields – This tab brings you to a screen that contains a listing of data from all of the tabs in the Claim Editor screen, and can be a useful place to find an unusual piece of data that may be causing a problem.

Important things to know about the Claim Editor buttons:

Map – Clicking the map button at the bottom of the Claim Editor will open the map that is currently being used for your batch. However, the data that it will bring up in its background will reflect the last print file you generated in your system. It does not necessarily use the data of the claim you are currently viewing in Claim Editor.

Verify – After correcting a warning, you should click on “Verify” to confirm that the error has been corrected. The error message should immediately disappear if the error correction was successful.

Ignore – This button should only be used if you know for sure that the data being labeled as incorrect is in fact correct. To un-ignore previously ignored warnings, highlight the warning and press ignore again. Click Yes when prompted to confirm.

Possible Problems and Causes:

Problem
Payments are going to a patient.

Causes

  1. “Medicare Participating” is not checked in the Provider’s File.
  2. There’s an amount in Box 29 of the CMS-1500 form.

Solution
To prevent this problem from happening, make sure that the “Medicare Participating” box is checked in the Provider’s file in the Setup/Provider/Provider File if the provider is a Medicare Participating provider. In addition, make sure that Box 29 in the CMS-1500 form reflects $0.00. If there is an amount showing, please double check your map and make sure that there isn’t an active field box sitting on top of Box 29.

Problem
Missing information for Commercial claims that you know is in your print file.

Cause
Commercial claims require more information than Medicare claims. If you used a Generic Medicare or Commercial map, some fields that are required for your commercial claims might not be activated or mapped properly in the map that you used.

Solution
Open your map and make sure that the following fields are enabled for the following claim types below:

  • Medicare Claim Fields: 1-3,5, 8,9a, 9d, 10a-c, 12-21,24a,b, d, e, f, g, j, 26-29, 32-33.
  • Commercial Claim Fields: In addition to the Medicare boxes, the following also need to be activated: 4,6,7,9b, 9c,and 11a-c.

Problem
The wrong Diagnosis code is appearing in Box 24E or there is no entry appearing in Box 24E.

Causes

  1. The field for Box 24E might not be activated in your map.
  2. Since SolAce did not find an entry in Box 24E it defaulted to show the first diagnosis code entered in Box 21.
  3. Your print file did not have any Diagnosis code entries.

Solution

  1. To check if the field for Box 24E is active and mapped properly, go to Setup/Maps and double click on the map you would like to check to open it into the Edit Map screen. In the Edit Map screen, change the setting in the Filter section at the bottom right hand corner from “Enabled Fields” to “All Fields”. Find the field for Box 24E on the fields list on the right panel and click on it once to select it. Once you’ve selected the field, SolAce will show you on the left (main) panel where the box is currently placed in your map. A check mark next to the field on the list will indicate that the field is active. At this time, please also look to see where the box for this field is placed in your map and make sure it is covering the correct information.
  2. If your print file did not include an entry for Box 24E, SolAce will choose the first diagnosis code that is entered in Box 21. To correct this problem, you can manually enter the correct code. You should also correct this problem in your Practice Management system and make sure that it will include the proper Box 24E entries the next time you export your claims.
  3. If your print file did not include any diagnosis code entries for Box 21 or Box 24E SolAce will not populate anything in those fields. Please correct this problem in your Practice Management system.

Printing Management Reports in SolAce

Reports
There are many useful reports that you can print in the Reports menu that contain valuable information.

Report Preview Buttons:

PDF-The first button on the toolbar will allow you to save a PDF copy of the report to your computer.

Print-The second button will send the report to your printer.

Arrows-The arrows on the toolbar will let you navigate to the first, previous, next, or last page of the report.

Zoom-The magnifying glass buttons will let you zoom in and out to see the report better on your screen.

NOTE: Reports consume considerable amounts of memory, so be sure to close the windows when you are finished looking at the report.

Type of Reports:

Reports/Providers
The Provider Listing report produces a print out of the SolAce Provider List sorted by type of entry and name. The Tax ID and several PINs are included on the report to make it a useful snapshot of your provider list.

Reports/Payers
The Payer Listing produces a print out of the SolAce Payer List. This report includes the same information you see on the Setup/Payers screen.

Reports/Patients
The Patient Listing produces a print out of the SolAce Patient List. This report includes the same information you see on the Setup/Patients screen.

Reports/Address
The Address Listing produces a print out of the SolAce Address Book that you have created. This report includes the same information you see on the Setup/Addresses screen.

Reports/Claim Status
The Claims Status Summary report displays a count of claims and total dollar amount for each status that SolAce tracks. This report operates on all data files present in the File/Manager screen, but does not examine archived data files.

Reports/Transmit
The Transmission Report produces a list of all outbound transmit files. It includes the control number for each file and an X next to each control number where a HIPAA compliant acknowledgment has been received. Use the Claims Listing Report in conjunction with this report if you want to track your transmissions closely.

Reports/Mailbox Activity
The Mailbox Activity report produces a listing of your mailbox’s inbound and outbound activity for a specified range of dates. For the outbound, it details out how much you have billed out to your receivers during your selected time frame, the number of records per batch billed, and the control numbers assigned to each batch. For the inbound, it details out the types of inbound reports you’ve received from your receivers and the dates they were received.

Generating your EDI file

Congratulations! Your file is ready to send.

Once you have finished correcting all of your warnings in the Claim Editor screen, SolAce will give you a pop up window letting you know that your batch is ready to send.

You can select "Stay in editor", "Close the batch", or "Go to the message center" to generate your EDI file.

Once you arrive at the Message Center screen the "Process Outbound" box will appear to let you know it has detected a batch that is ready to be sent. Push the "Generate" button to generate your EDI file.

NOTE:Only files assigned to an electronic mailbox will generate an outbound file. If your claims are assigned to "Paper", they will continuously appear in the Process Outbound box until you change their status to "Sent Manual" or "Sent Paper".

The Process Outbound Box

Prior to pressing the "Generate" button, you may deselect certain batches from the "Select" column if you are not ready to generate them.

Problem
The Process Outbound box does not automatically open even though there are electronic batches that are "Ready to send".

Cause
The "Always show this screen automatically" box has been unchecked on the Process Outbound box.

Solution
Click the "Out" button on the bottom left side of the Message Center screen. When the Process Outbound box appears, check the box for "Always show this screen automatically".

Working in the Message Center Screen

Message Center

To go to your message center where you will actually transmit your files, go to File/Messages.

The message center consists of 3 panes; an Outbound pane (located at the top half of the screen), a Preview pane (located at the bottom half of the screen), and a mailbox list pane located on the left side of the screen. Each of your mailboxes listed on the left pane will contain its own outbox, inbox and archive folders. The archive folder will also contain and outbox and inbox folder to separate your archive files.

NOTE: When calling a payer for any reason, such as checking on a claim’s status, they may ask for your submitter ID; this is the number found in the mailbox list on the left pane of the message center.
It is also helpful to note that when a user has multiple mailboxes, the name of the receiver for each corresponding submitter ID can be found by placing you mouse over the submitter ID's found on the left.

Important things to know in the Message Center:

Outbound files - All outbound files are automatically archived after they are sent, and can be found by clicking on your mailbox ID/archive/outbox folder. Each outbound file is assigned a Ctl (control) number which is often referenced in the reports you receive back from your payers.

Inbound files - All inbound files are archived after you double click on them and view them. If you prefer to use the preview pane at the bottom instead of opening the full report, it is your responsibility to manually archive the report by pushing the "Archive" button in the middle of the screen.

Sending – Files are automatically sent every 10 minutes or so. However, you can choose to send your batch at a preferred time by clicking the calendar button at the bottom left just below where it says “Next Send” and choose a desired date and time to send. Or the batch can be queued for immediate transmission by clicking “Now" and "Schedule” instead of entering a date and time

Receiving – Files can be received the exact same way as the “Sending” procedure above by using the calendar button next to “Next Receive.”

Load – this button can be used if you receive files from a payer by another means, such as a web portal, and need to load the file you downloaded into SolAce (such as an electronic EOB).

To Batch - If you go to a mailbox/archive/outbox folder and select a previously sent file, you may click this button to be automatically transferred to the Batch in the Batch Editor screen. This is a very helpful feature when trying to resolve issues with previously sent batches that need resending.

Cancel - If you mistakenly generated an outbound file, you may highlight the file and press the cancel button to remove it from the outbox folder.

Possible Problems and Causes:

Problem
Duplicate “Next” Control Number

Cause
A Control Number (found under the “Ctl #” column) is a number SolAce assigns to an outbound batch before it is sent. This same number is used to match inbound files that are later received for the original corresponding outbound.

NOTE: Not all inbound files have control numbers

  • There are scenarios where an outbound batch will be assigned the same number as a previously sent batch. SolAce will detect this and give an error that says “error running outbound processing, the mailbox has the next control number of __, but there is an outbound archived batch that already uses this number.”

Solution
To fix this, go to Setup > mailboxes and double click the mailbox that you are trying to transmit with. Then click on the Advanced tab in the mailbox properties and change the value of the “Next control #” to a number that is 10 greater than the current value. Click OK, save, and try the transmission again.

Working in the Search Screen

Searching for claims

The Search screen under File/Search is very helpful in helping you search for a patient’s record in the batches that you have imported into SolAce.

When you search for a claim please make sure that you select the correct “Tran Type” or type of claim. Not all fields are required when conducting a search. For instance, if you wanted to find every claim for patients with the last name smith, simply type “smith” in the last name field and click Search. However, you must specify the correct last name and/or first name when searching. Please also keep in mind that the name fields are case sensitive when searching on the Desktop and Multi-User versions of SolAce.

How To Get Help

Contacting Our Support Team

If you are having issues with SolAce, the Support Handbook is a great place to browse and ask for help. Chances are your question has been asked before so try searching the archives first.

If you would like to talk to a support representative instead, please give us a call at (602) 439-2525 or send an email to support@solace-emc.com. Please remember that unless you have purchased a specific support package, support is given at a rate of $25 / 15 mins. with a minimum charge of $25 per call or e-mail.

If the issue you need help with will require analysis of protected health information then you should call, fax, or email rather than using the public forums.

Frequently Asked Questions

Is SolAce HIPAA compliant?
Yes. SolAce can produce claim data in the ANSI 837 Professional and Institutional formats, and can process several other related transactions. The ANSI 837 file format is technically referred to as ASC X12N 837 (00401X098A1). Full specifications can be found at the Washington Publishing Company's web site at www.wpc-edi.com.

Is SolAce compatible with our practice management system?
Yes. SolAce integrates loosely with your existing practice management system, extending it to give you the control you need for today's complex insurance billing tasks. Our unique tool lets your staff and practice management system do what they are best at, and SolAce snaps in to bridge the HIPAA transactions gap. The single, critical requirement is that it must produce consistently formatted output files.

What happens after I order SolAce?
We'll help you get started as you place your order by inquiring as to what payers you need to submit to. If you need enrollment for any of the payers we can point you to the correct forms and advise you while you fill them out. We can also recommend the optimum way to submit your claims with our combination of "Direct Connections" plus clearinghouse features. Some customers choose to submit all their claims to the clearinghouse and pay for the print-and-mail service for non-electronic payers. Most customers have a lot of government claims and it is beneficial to get a Medicare submitter ID plus a clearinghouse ID.

You will receive your software CD-ROM in 5-10 days if you ordered a version that gets installed at your site. The SolAce Support Team can provide a download link if you want it sooner. Once your order is processed our support team will contact you to schedule a setup call and a training call. Both are about 1 hour long. Typically, these calls are full of information so we suggest the primary user be the one to work with our support team for these calls. The support team often uses a web meeting tool to give the user training - it's almost like having the support team right there with you.

The enrollment and setup assistance is covered by your Setup Fee for what we call our Basic Support plan. There will be no extra support charges during your setup period unless you opt for an on-site installation and training session.

How easy is it to setup SolAce?
We have complete step by step instructions in our manual to walk you through the setup process. We also provide computer-based training tutorials on a CD-ROM to show you how it works in an animated, visual way. Our support team makes the setup call a breeze for you to install the software.

The overall setup process that you can expect is outlined below.

  • You will need to enroll with payers for submitter IDs and add them into SolAce as mailboxes.
  • You need to generate claims from your practice management system and import them into SolAce to test it out. The most difficult part for new users is getting the print file mapped. This is a visual, drag-and-drop interface, and is very easy to work with once you understand how it works. It is the most intuitive mapping interface we've seen out there.
  • You need to add your provider ID numbers into SolAce, by entering them manually or preparing a CSV import file if you have hundreds of providers to add.
  • If you will be transmitting to any payers via a direct modem connection you will need to setup and test your modem information.

We have an online Flash demo you can watch that takes you through the setup process. This is one of the components that we provide for documentation and training purposes.

On top of being easy to use, SOlAce is supported by a dedicated team at 602-439-2525 or support@ivertex.com.

How much memory do I need to run SolAce?
On newer operating systems like Windows XP and Mac OS X you will need at least 256MB of memory because the operating system consumes a lot of memory. We recommend more than 256MB on all computers because memory is very inexpensive and gives you the most bang for your performance buck of any computer component. You should also have at least 100MB of free disk space for the software to install and for data storage of claims, transmit files, and configuration settings.

How do I print to a file?
Almost every practice management system has a feature that allows you to send the printed claims to a file, because that is how you would submit to any clearinghouse in the marketplace. This is the ideal situation because you can set the destination file in your printing step. Most systems that have this feature will save the setting for you too, so you can just set it and forget it.

Is there an additional fee for the clearinghouse?
If you purchased SolAce EMC prior to December 10, 2003 there is a $200 setup fee to add the commercial claims option. Sales after that point included the commercial claims option as part of the base package.

Our preferred clearinghouse partner is Availity (formerly THIN). Their payer list includes access to around 1,100 payers at no extra charge. You do have to sign a user agreement with Availity that is separate from any agreements related to SolAce EMC™.

If you choose to go with another clearinghouse that we support there may be payers on their list that are called non-participating, which means the payer accepts claims electronically but does not participate with clearinghouses for their revenue model. These payers are primarily the Medicare, Medicaid, and Blues plans that are often part of our "Direct Connection List" in SolAce that you can reach at no charge.

We recommend using SolAce Electronic Medical Claims™ to send commercial claims to Availity, and your Medicare, Medicaid, and BCBS claims direct to those payers. It really is the best of both worlds.

How do I bill Medicare Secondary Payer claims?
There is a great reference including links (though some are broken) to the CMS manual on Noridian Medicare's web site at https://www.noridianmedicare.com/dme/news/manual/chapter11.html.

Our SolAce Support team hosts free training calls to teach your staff how to bill the secondary claims. Please send an email to webdemo@solace-emc.com to find out when the next web based training class will be held.

What platforms will SolAce run on?
SolAce is available for Microsoft Windows(tm), Linux, Mac OS X(tm), and any other platform that supports Java(tm) 1.4 or higher. We have tested SolAce on the following operating systems.

  • Microsoft Windows 95, 98, ME, XP, and Vista
  • Windows NT 4.0 Workstation and Server editions
  • Windows 2000/2003 Professional and Server editions
  • Novell Netware version 4 or higher networks
  • RedHat(tm) Linux 7.x, 8.0 and 9.0, Gentoo Linux 2004+, Mandrake Linux 8 or higher, Debian Linux 3.0r1
  • Any Linux or Unix distribution that supports Java and XWindows should work fine
  • Mac OS X (version 10.2 with Java 1.4 installed, or version 10.3

How soon can I submit live claims with SolAce?
If you have your submitter ID, output file from your practice management system, claims and your provider numbers you could send claims in a matter of a few days. Typically, the commercial mailbox for Availity is the quickest because the submitter ID is often sent back in about 3 days.

For direct links most payers have us certify as a vendor, then you have to enroll to get a submitter ID and send a successful test batch. The payer will move you to production status within a few days of that transmission. Some of our direct links allow you to go directly to production, although we still advise sending a test to get familiar with their system and ensure that your reports come back in a timely manner. It usually takes 2 weeks to get your submitter IDs, assuming you enroll when you order SolAce, so you can be sending live claims within about 3 weeks.

We strongly recommend reviewing all reports that come back from payers. These reports show up in your Inbox on the Send/Receive screen after a transmission. Some reports are fairly useless, and others are very important to review to ensure your claims are accepted by the payer's claims processing system.





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Payer Setup

How does SolAce send claims to multiple payers?
SolAce determines how to route each claim on an individual basis. The payer on the claim has to first be resolved to a payer in the SolAce payer list. This can be accomplished in one of two ways:

  • Use the same ID or Name that SolAce has on its payer list for the claims that you import, or
  • Add an alias for the payer the first time SolAce tells you the payer doesn't match to one in the list. This is done by clicking the Search button and picking the correct payer, then answering Yes when prompted if you want to setup an alias.

You can mix claims for different payers into a single batch unless you have different billing requirements for the payers. For example, some specialties have to bill Medicare differently than they bill other payers, such as Chiropractic, Ambulance, Podiatry, and PT/OT specialties. If this is the case for you then you may need to separate your Medicare claims from all the other payers before you import into SolAce.

Secondly, the billing provider on the claim has to be resolved to a provider in the SolAce provider list.

Once the payer and provider are resolved, SolAce then finds the best route for the claim using the mailboxes that you have setup on the Setup/Mailboxes screen. Direct connections are displayed as zero cost even though there may be long distance or ISP charges involved. Clearinghouse connections can vary in cost because clearinghouses charge different rates depending on their contract with the payer or other clearinghouses. SolAce estimates clearinghouse charges for you based on whatever clearinghouse data it has loaded, and will display the estimate on each claim and on the Send/Receive screen before you transmit the claims.

You can see the route that SolAce selected for each claim by checking the Mailbox field in the Claim Editor screen. This field is present in both the claim form views and on the Payers tab, located just below the payer field.

Provider Setup

How does SolAce handle provider ID numbers?
SolAce supports multiple payers and communication channels, and payers have differing requirements on the Provider ID numbers (PINs) and NPIs that need to be used on their claims. To accomodate all the different requirements, SolAce has built-in support for very complex provider setups. SolAce tries to present this in a very user-friendly way so that providers with simple setups aren't overwhelmed, but providers with complex setups are not limited by the software.

For starters, SolAce requires setup of a provider list. There are multiple reasons for this, most important among them to be able to provide good edit checks for new electronic claim billers, and to support the provider data requirements of the HIPAA 837 transactions.

Provider Types
Each provider in the SolAce provider list has an entry type that is easy to understand, but tells SolAce an important piece of information about how the PINs and NPIs for that provider can be used. The table below shows the provider entry types along with the information that SolAce gets from that entry type.

Provider Type Valid as a
Billing Provider
Valid as a
Rendering Provider
Notes
Solo Practice/Organization  
Group Practice   Will have no UPIN or taxonomy code. Used for Facilities also.
Group Provider   Will have no address, and will always reference a billing provider (a Group Practice) for name, address and Tax ID.

General PINs
Each provider in the SolAce provider list has a Tax ID or SSN. Group Providers have an SSN but it is never transmitted and is only used in rare cases for matching an SSN on a claim form to an entry in the SolAce provider list.

Each provider also has a list of General PINs, which are provider ID numbers based on a payer's Plan Type (also known as "line of business"). Examples of General PINs are Medicare PIN, Medicaid PIN, and BCBS PIN. Plan Type corresponds to payers because each payer in the SolAce payer list has a Plan Type. SolAce determines which PIN to use for an individual claim by looking at the payer and provider number on that claim. For a Medicaid claim it will try to locate a provider with the Medicaid PIN on your claim. If there is no matching PIN for the payer a match will be attempted based on Tax ID.

As an example of how this works, assume you have a claim imported into SolAce with the payer identified as Virginia Medicaid and a PIN in box 33 of 12345. Virginia Medicaid's entry in the SolAce payer list indicates that the Plan Type is Medicaid. In this example, SolAce will try to locate a provider entry with a Medicaid PIN of 12345. Once located, the provider entry tells SolAce everything it needs to know for edit checks and transmission. If no PINs are provided, SolAce will search based on NPI and/or Name.

There are always exceptions, and for everything we have covered up to this point there is a way to override the default behavior.

PIN Overrides
The PIN Overrides feature in SolAce is where the ultimate in PIN flexibility resides. This feature lets you build a list of payer-specific provider ID numbers. PIN Overrides take precedence over the General PINs we just covered.

To add a PIN Override you select the payer and enter the PIN that should be submitted for that payer. The PIN Overrides list is checked before the General PINs or Tax ID, both during editing and transmission. This allows you to print one PIN on your claim form and set it up in the General PINs area, but override it for electronic claims by adding an entry to the PIN Overrides list.

In addition, you can override whether the PIN is valid for use as a billing or rendering provider number. Remember what we covered in the Provider Types section above about the different provider types being valid for billing or rendering usage? The PIN Overrides feature lets you override this default behavior for individual payers to allow use of a PIN as billing or rendering. SolAce also tries to default this sensibly, such as allowing Group Practices to be used as Rendering providers on commercial claims.

Scenarios
Some of the more complex scenarios are described below with a description on how SolAce would be setup to handle the situation. Keep in mind that each scenario might be payer-specific, and SolAce can handle each scenario separately by payer. In other words, you might have one scenario that applies to Medicare, and another that applies to Medicaid. You would just combine the different setup techniques described below to handle all your payer's requirements.

Scenario Provider Setup
Group number for the office and individual numbers for each physician.
In 1500 form terms this would be your office name and group PIN in box 33, and individual name and PIN in box 31 and 24J respectively.
Add the office as a Group Practice, then the individuals as Group Providers. Enter the Medicare Group ID in the Group Practice's Medicare PIN field, and the Medicare PINs in the individual providers' Medicare PIN field. For Noridian submitters, use the PIN Overrides feature to supply a different PIN for electronic claims than you would typically use for paper claims.
Billing provider is a company, but the individual providers don't have PINs and get billed using a company PIN for all or most of the providers.
In 1500 form terms this would be your office name and PIN in box 33, and an individual's name in box 31. This is a common setup for commercial payers where the Tax ID is used as the PIN.
Add the company as a Group Practice. Go to the PIN Overrides feature for the Group Practice and add a payer-specific PIN with the Rendering checkbox marked to indicate the group PIN can be used for the rendering provider ID. Be certain to map the RENDERING-NAME field to box 31 or 33 in your map because SolAce will not be able to pull the name from the provider list in this case.
If there are also individuals in the mix that have specific PINs for themselves, then add those individuals as Group Providers related to the Group Practice. Enter general or payer-specific PINs for these individuals and it will be used with the Group Practice PIN on the claim.
Billing provider is a company, but some individual providers have PINs and should be billed as the billing provider.
In 1500 form terms this would be the physician's name and PIN in box 33, even though they are part of a larger group of doctors.
Add the company as a Group Practice, then the individuals as Group Providers. Use the PIN Overrides feature to enter the PINs on the Group Provider entries, and mark the Billing checkbox to indicate the individual PIN can be used for the billing provider ID. If you also have a PIN at the Group Practice level it will only be used for Group Providers that have PINs without the Billing checkbox marked. The Group Practice information is still used for Address, Contact Person, and Tax ID.

Advanced Topics

This section has advanced topics that few users should need.

How to setup a dial-up network connection

Windows™ Family

This Microsoft® page has all the information for setting up Dial-up Networking connections on Windows.

Network and Dial-up Connections

Mac OS X Family

Open the Internet Connect icon in your Applications folder.

Click on the Modem tab at the top.

Click the + button to add a new connection. Enter the phone number, login ID, and password in the fields provided.

Click the Connect button to connect.

While connected the screen will look like this. Minimize it, or you can close it and use the phone icon at the top right of your screen to get it back later.

Click the Disconnect button to disconnect, or use the phone icon at the top right of your screen.

Linux

This one is not for the faint of heart...

Linux PPP HOWTO





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Practice Management Systems

This section includes tips and instructions from our customers on how to print to a file with practice management systems. These instructions are not intended to be a step-by-step guide for every provider's office to follow, but they should point you in the right direction for you to determine your own office's billing process.

SolAce EMC™ can be utilized with any system that has the ability to print a consistently formatted print file, NSF/UBF File, 837P/837I file, or Comma Separated Value (.csv) file with consistent headers.

Trademark Notice
The names of other companies, products and services are the property of their respective owners. Including the following:


The Medical Manager by Sage™


McKesson Information Solutions LLC
Medisoft™
Lytec®


Medlook by Fagerman Technologies, Inc

Export claims from Medisoft™ for DOS

  1. From the Operations/Main Menu
    Select 5) Billing Operations
    Select 2) Print Patient Insurance Forms from the submenu
  2. From the Print Patient Insurance Forms screen, select a form to use (A-Z). For Medicare, use Medicare HCFA-1500 Century or Century Lsr or your previously formatted form.
  3. Arrow down to the Range of Primary Insurance: field and type in your Medicare Insurance Carrier number, such as 1-1.
  4. In the Range of Secondary Insurance: field, type 0-0. Note: This eliminates any secondary claims from printing. If you use any other parameters in the above section, you should continue to do so. Generally you can arrow down until the screen changes to the Print Selection screen.
  5. If you have not setup a virtual printer in 1) Set Up Practice - 2) Setup Up Printers, select F for File: and enter a file name in the pop up field that appears, ie., Medicare.txt or Commercl.txt

If you have created a virtual printer in the Set Up Practice / Set Up Printers menu options, select the proper printer item in the above. Hit enter and Medisoft will now save your claims to the file specified. Generally, the file will be saved to c:\medisoft\medicare.txt, or whatever name you chose.

We recommend you use the same filename each time you print to a file. You can also format your insurance form to default to commonly asked questions while in print mode and to save to a predetermined location and file name. This is done in the 1) Set Up Practice - 5) Format Insurance Forms. You may need to contact your Medisoft vendor for help in setting this function.

During the setup of SolAce the Print File field should now be specified to read c:\medisoft\medicare.txt, or whatever name you chose above. This will allow SolAce to find and import your claims.





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Export claims from Medisoft™ for Windows

This product has two options to create a claims print file.

Paper Claims Method

If you do not plan to bill commercial claims using SolAce, the easiest method is to export to a file.

  1. Create claims in Claim Management as you routinely do.
  2. Click on Print/Send and select Paper as the billing method.
  3. Select CMS1500 (Primary) Medicare Century or the Medicare form you typically use to print your claims to the printer, and click OK.
  4. Click on the {{Syntax|Export the report to file}} radio button and then Start.
  5. On the Save As screen, browse to a location that you want to save your file to. This should be the same location each time you save your claims in the future.
  6. Give your file a name in the File name: field. Click on Save. Do not add an extension to the file name. Medisoft adds .txt automatically.
  7. In the Data Selection Questions screen, select the appropriate Insurance Carrier 1 Range for Medicare. This should default to the appropriate carrier if you are using a true Medicare form from step 3 above. No other selections on this screen are necessary unless you routinely use them. Click OK.

A printing process and update process screen will appear as Medisoft creates your file.
The claims are now saved to a file in the location selected in steps 5 and 6 above.

For best results, the following settings should be selected on the Options tab for each insurance carrier you wish to bill:

  • Patient Signature on File = Signature on File
  • Insured Signature on File = Signature on File
  • Physician Signature on File = Print Name (prints in box 31 on CMS-1500)
  • Print PINS on Form = PIN Only (prints in box 24J on CMS-1500)
  • Default Billing Method = Electronic

EMC Receiver Method

An alternate method is suggested if SolAce will be used to electronically bill claims for more than one payer such as Medicare. This method uses the EMC Receiver setup feature of Medisoft.

  1. Select EMC Receivers from the Lists Menu bar at the top of Medisoft.
  2. Click on New at the bottom of the screen.
  3. Give the new receiver a code name, i.e., SOL or any name up to 5 characters. Give the receiver a Name: i.e., SolAce for Medicare.
  4. Click on the ID and Extra tab.
  5. For your Medicare claims, type CMS11.EXE in the Program File: field. If you have the commercial claims option on SolAce, create another receiver and type HCFA11.exe in this field. (If your Medisoft installation uses different file names contact your Medisoft support for the exact name to enter here.)
  6. Type the number 83 in the Extra 1: field if any of your provider PINS contain more than 8 characters in box 24J of the claim form.
  7. Click on Save.
  8. Go to Lists and open your Medicare insurance company and click on the Options tab.
  9. Change the Default Billing Method: to Electronic. If using SolAce to bill commercial claims, do the same to each of the commercial insurance companies.
    Note: Compare your list of companies to the clearinghouse list found in SolAce or the this website. Only those listed in your copy of SolAce after you have added your mailboxes are eligible.
  10. Click on the EMC, Codes tab and choose the EMC Receiver code you created in step 3 above. If using SolAce to bill commercial claims, do the same to each of the commercial insurance companies. Click on Save when complete.
  11. Create claims in Claim Management; claims will now show EMC in the Media 1 column.
  12. Do a Print/Send when you are ready to bill, choose Electronic as the billing method and select the Electronic Claim Receiver you created in step 3 above. Then click OK.
  13. Click on Create File on the next screen.
  14. Make note as to where you will be saving the file to in the Save in: field. You should always save to the same location. This filename goes in SolAce on the Setup/User Options screen to make the circuit complete.





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Exporting claims from Lytec® 2000 or newer

  1. Open the Edit Custom Report feature, Click on Reports then Edit Custom Report
  2. Select Text-Medicare HCFA 2000.lci, Click on the form then click on Open
  3. Make a Copy of the form, Click on Options. Click on Save As, give it a name, i.e., SolAce.lci
  4. Change the setup of the form by selecting Setup from the Options menu button. Click in the Print to File box to activate. Click in the Print to This File field. Give the file a name including a path, i.e., C:\Claims\SolAce.txt
  5. Click on OK. From the Options menu, select Save. Now Close.
  6. On a daily basis, you will enter your claims throughout the day and save as you go. When you are ready to do your Medicare billing in a batch, go to Print Insurance Claims from the Billing menu. When you are presented with the forms selection screen, you will choose the form named above in step 3, i.e., SolAce.lci
  7. Select form and click on Open
  8. Follow the normal steps as you would when printing to paper claims. Make sure you select the insurance company as Medicare. When you continue, the claims will print to a file called SolAce.txt rather than to the printer.





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The Medical Manager™ by Sage Integration Notes

Well, we can't call this one a full article yet because integrating with Medical Manager is a tough one.

What we do know is that the Medical Manager produces claim files that can be transmitted with SolAce EMC instead of via the default clearinghouse. However, you should review your contract with Medical Manager to ensure this is legitimate use of your system.

If you have any experiences to share, revisions, or additions to this document that may help other users in the future, please edit this page and add your own notes. Below are the notes we have so far.

Acknowledgments
Big Thank You's to the freelance technicians who know The Medical Manager and have contributed to this document.

Printing Claims to a File
The Medical Manager supports generating HCFA-1500 print images to a file, just like it can do to a printer. By default The Medical Manager only comes with one form, and you will want to refer to the section on splitting claims below if you need more flexibility.

The trick is to go into the setup program that was used to initallly setup the system, and define a printer device as A:?. This instructs The Medical Manager to print to a disk file and ask you for the filename at the time of printing. You can also use a filename instead of a question mark if you want the claims to print to the same file every time.

The A: may look like a floppy disk drive letter to Windows/DOS users, but it is a device designation. Drives are aliases to these devices that you can setup in the setup program.

This technique and an example is covered in The Medical Manager documentation, in an Appendix section titled Application to Printer Map.

Once you have the form setup you use the Medical Manager menu named Billing & EDI, then choose Insurance Billing for Paper Claims to do a run of claims to your print file.

Notes on Filenames
Here is what filenames on our system look like:

30   09/26/03    A:NEICMCAR.030         33   10/01/03    A:NEICMCAR.033 
31   09/29/03    A:NEICMCAR.031         34   10/02/03    A:NEICMCAR.034 
32   09/30/03    A:NEICMCAR.032         35   10/03/03    A:NEICMCAR.035

Notice the filenames after the A:? those are the actual emc batches that are sent out (ie, NEICMCAR.032). Chances are, the A: is the c:\meddata directory (most installations default to meddata as the first drive). The A: is an environment variable that MM reads from a batch file (type "set" to see it from the command prompt). MM increments the file extension to know which batch to roll back should you need to (In this example, batch 32 done on 9/30).

If you save the file and it says EMC BATCH FILE STATUS REPORT at the top then you've saved the batch summary. Look on that summary report for the actual filenames that contain the EMC claim data, and save those files off instead.

Transferring a print file from a Unix server
Users of The Medical Manager that are running a console-only Unix server will need to run SolAce EMC on a workstation that runs a graphical desktop (Windows PC, Mac OS X, or Unix/Linux with XWindows installed).

Copying via FTP
There are two ways of retrieving the claims file from the Unix server. One way is to use an FTP client utility to copy the file over. We recommend the free and very easy to use FTP client named FileZilla, available for download at http://filezilla.sf.net.

As of SolAce version 2.1.14: The other way is to use an FTP URL in the SolAce System Options screen. This requires you to put the username and password for your Unix server login, as well as the full path to the print file, in SolAce. Go to Setup / System Options on the menus, then enter the FTP URL in the print file or NSF file field, depending on what type of file you will be importing. An example FTP URL is ftp://username:password@myserver/tmp/claims.txt. This would cause SolAce to try downloading from the FTP server named myserver, with a login of username and password of password, the file named /tmp/claims.txt residing on that server.

Copying via Floppy
We had to copy the file off our Medical Manager system with a floppy disk. This is done by using the Unix console and entering a \copy command. This prompts for the filename and then copies it to the floppy disk.

Splitting Claims
Some SolAce EMC users have needed to separate the claims into separate batches to avoid sending all the claims to SolAce for processing. This has been the case when a payer is not on any electronic payer lists, and when the user would rather print them to paper than use the clearinghouse's print-and-mail service for .XX cents per claim. This might also be useful if you want to format the claim forms differently for Medicare versus other payers, as would be the case for Ambulance companies, for example.

To accomplish this you have to make a copy of the form you normally use. You can find the format files for the claims forms in The Medical Manager's installation folder. The file names start with "ins", are followed by two 2-digit numbers representing the form and format, then a letter like a (paper) or c (EMC), and a ".fmt" file suffix. An example of form #1 and format #1 for paper claims is ins0101a.fmt.

You can find out what form/format is being used for your claims currently by visiting the Claim Center feature (type /m13 for menu 13) in The Medical Manager. Look at the specific claim center and see what form and format is being used. If the form is 2 and format is 3 then the format file it is using would be named ins0203a.fmt.

To duplicate the form just make a copy of the format file and name it in the right convention. For example, if we want to make a copy of form #2 format #3 so we have a form #3, we would copy the file named ins0203a.fmt to a file named ins0303a.fmt. Then, go back to the Claim Center feature in The Medical Manager and attach to the form/format by specifying the new form and format numbers in the claim center.

If you want to actually alter the form to make it different then you will have to consult with a The Medical Manager technician or edit the insXXXXa.fmt file to change your formatting. Altering the form is beyond the scope of this tip sheet.

Print Image vs. NSF Files
SolAce EMC can import claims from a print file or National Standard Format (NSF) electronic claims file. Our Medical Manager users so far report good success with the print file option, although it is reportedly a pain to setup for non-technical users. We have also heard that if you are already using The Medical Manager's add-on for electronic claims then your system has the capability to produce NSF files, which SolAce can then process for you. We have no specific instructions on how to generate NSF files from The Medical Manager at this time, other than you would just transfer the NSF file to SolAce rather than letting it transmit to the clearinghouse.





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