• Filling in the new NPI Fields in the program

• Selecting the correct CMS Form (formerly called HCFA) and aligning them.

• Selecting the correct program for submitting Electronic Claims

• Getting Familiar with What Medicare has changed with this new format. 

• Something missing when you go to print?

Provider Class - Setup a new Provider Class (Select "List", "Provider", "Class", NEW)
Hit the F1 key and it will give you an explanation and example of what you need to input here. 

Providers - Edit your provider information in Medisoft (Select "List", "Provider", "Providers", "Edit")
Select "DEFAULT PINS" and enter your NPI number in the National Identifier field.  On your "DEFAULT GROUP IDs" you can add the CLASS that you entered in the Provider Class step above.

Referring Providers - Edit your referring provider information in Medisoft
(Select "List", "Referring Providers", Find the provider, then select "Edit")
Select "DEFAULT PINS" and enter the NPI number in the National Identifier field for the referring provider.

Facility - Edit your provider information in Medisoft (Select "List", "Address", Find your facility then select "Edit")
Select "DEFAULT PINS" and enter your NPI number in the National Id field.

Patients - In the Patient Information screen, be sure you indicate under the Entity-Type area that the patient is a PERSON.  Otherwise, you'll get claims rejected for Missing First Name and Last Name.
 

The HCFA forms are now being called CMS Forms, so you should notice about 7 new forms in your selection list. 

The main form you will be using for Primary insurance will be the CMS - 1500 Primary. 
Print a test claim with this form to see if the form needs to be aligned

To Align Your Form:

1. Click on "Report" "Design Custom Reports and Bills"

2. Click on "File" then "Open Report"

3. On the Right hand side of the window that opens, select "Insurance Form"

4. Select CMS- 1500 Primary

5. Once it opens, click on "File", "Report Properties"

6. Now make minor adjustments in the fields for "Form Offset", "Left" and "Top".  This will move the entire form either left, right, up or down to align with your printer.  This may take a few attempts to get everything lined up properly.

7. When you go to save your form, put the letter "A" in the title (Ex: "A CMS Primary")  that way the form will alphabetically come to the top of your choices so you don't have to hunt for it every time.

Ensure that you have the latest software to use with your program. 

Medisoft Direct Claim Module V11- If you have purchased the Medisoft Direct Claim Module for Version 11, be sure that you have the latest Service Pack 4 (available in our download area). 

Electronic Claims with RelayHealth - See our MedAvant Setup instruction page

Electronic Claims through Third Party Clearinghouses (ENS, WebMD, Gateway, etc)  - Modify your EDI Receiver setup - Click on "List" "EDI Receiver", then select the EDI Receiver you normally send claims with.  Select "ID" tab, then in the PROGRAM FILE change the name  "HCFAFILE.EXE" to "CMSFILE.EXE" or if it is "HCFA11.EXE", change it to "CMS11.EXE" ONLY if HCFAFILE or HCFA11 are currently listed in that field.

CMS (HCFA) 1500 - New Revision 08/05 Instructions for use
CMS (HCFA) 1500 - New Revision 08/05 What Has Changed?
CMS (HCFA) 1500 - New Revision 08/05  Form for use in October, 2006
 

One of the coolest features Medisoft includes in their Help section is the "Clickable CMS Form".  All you need to do is click on any field on the form, and Medisoft will tell you where in the program you will need to put information.  (Ex: Box 17b - Referring physician National Provider ID. This information comes from the Referring Provider window, National Provider ID field).

To find this Clickable form, select "HELP" at the top of the window, then select "NDC Medisoft Help", then Select "INDEX", then type "CLICK" and you will be able to select the "Clickable CMS - 1500 form"