Highlight desired patient; press to display listing of Encounter Forms. /'alfahlp' The HCFA Claims will be appended into a single DOS file named "MCAID.ASC", and the EPSDT Claims will be appended into a file named "EPSDT.ASC". Because you do NOT want to append a new batch of claims to an old (previously transmitted) file, you should first delete any prior claim files. (The prior file should have already been saved elsewhere.) Then create your new claim files. 2'dcdhlp' The next five fields require a response of Y or N. provides the default response of N for all five fields with a single keystroke. -'dfhlp' All data entry for the batch of claims should have been completed before proceeding here; if not, go back to the Main Menu and continue claim preparation. Here you will create a DOS file containing the claims formatted for electronic transmission. Note there are 6 separate routines for the HCFA Claims depending on the number of detail lines. All of these should be run unless you are sure no claims have been prepared for a particular option. (No harm is done if you run an option for which there are no claims.) All HCFA claims (Medicaid & Medipass) are appended together in a single DOS file named MCAID.ASC. Add the end-of-file (EOF) marker when done. This is the file that the modem will use to actually transmit the claims. There is also a routine for EPSDT Claims; run this if you have done any. The EPSDT claims will be appended together in a file named EPSDT.ASC. Be sure to add the EOF marker when done. When finished here you should exit LEHICAID and go to the DOS level. There you should copy the files (MCAID.ASC and EPSDT.ASC) to the directory where the modem program is located. ?'dsmenhlp' The provider here is the "billing provider"; this is the provider or group who is to receive payment from the claims. The provider actually performing the service may or may not be the same as the billing provider. -'ephlp1' The Keyed Claim Type is a code associated with a particular provider type. These codes are available in the Medicaid handbook. The code that a physician must use is 01. The field defaults to this value at program startup. You may overwrite this value should this ever be necessary. 0'ephlp2' The EPSDT well care code is the diagnosis code for well baby and child care to be used with EPSDT billing. This code is currently V202. The program defaults to this value at startup. You can overwrite this if necessary. 1'ephlp3' This is the form for prepration on an EPSDT Claim. Sequence No: identifies claim. First claim each day should be Increment each succeeding claim by 1. Other Ins: Select N or Y. Treating Provider: Use Alt-P to select. Today's Date: Required entry. Beeps if not the same as DOS system date. Diagnosis and codes from the Encounter Form are displayed. These are the codes that should be used in this form. Detail Section: Enter Place of Service (01,02,03); Diagnosis Code; Exam Code (1,2,3); and Refer Code (0 7). Pressing at the first DiagCode field enters default responses: V202 (well care) under DiagCode; 1 under Exam Code; 0 under Refer Code. These items may also be individually completed. Use Alt-P for provider. Othr Ins Pay: Entry is ususally 0. Lab & Immunization indicators: Enter N or Y <'epshlp' Press to select the highlighted Encounter Form which will be used to prepare claim data. You will be given the option of preparing a HCFA 1500 or an EPSDT Claim. After completing data entry, you will be returned to this table. You may then press for the patient list to select other patients. 0'gtefhlp' imMEDIHLP2 This is the form for preparation of HCFA 1500 (12-90 version) Medicaid or Medipass claims. The fields to be completed are in reverse video. HEADER (upper portion of form) . . . Sequence number identifies claim. The first claim each day should be 1; each succeeding claim should be incremented by 1. Today's Date: Beeps if not the same as DOS system date. Other Insurance; Employment Accident; Other Accident; Motor Vehicle Accident; Outside Lab Indicator: These fields need a Y or N response. provides the default response of N for all of these fields. Referring Provider No: If this is a consultation or referral form a primary Medipass provider, enter the 7 digit referring physician no. and 2 digit location code (if not known enter 00). Prior Authorizaiton Number: Enter if applicable. Press Enter for more help. A'medihlp' DETAIL Section of form . . . Complete the number of detail lines (maximum 6) appropriate for the claim being processed. The number (1 6) of detail lines done must be entered in the lower right corner of this screen. takes you to the end of the form when you are finished. shows Diagnosis Codes that may be used in this form. shows Place of Service Codes. Press this key when on the OthPay field to get default responses for the remainder of the detail line. Default responses are-- OthPay is blank; Prv is the number of the billing provider; E (EPSDT related), F (FamPlan), and M (Emergency) are N. These fields may also be completed individually. when at the provider (Prv) field, pops-up a list of providers. There may be times when the provider who actually performed service was not the billing provider. Press Enter to quit help. >'medihlp2' LEHICAID Version 3.1 (Revised 03-04-95) This program will prepare Medicaid, Medipass & EPSDT claims for electronic submission via modem. To do so, you should have previously completed Encounter Forms (in the LEHIPEDS main module) for the services to be billed. The claims prepared here are then exported to the UMAP Program: this is a modem program supplied free of charge by Florida Medicaid. The first step involves completing provider data from the first menu option. This must be done for each batch of claims when you start the program. 5'strthlp' ALFAHLP DCDHLP DFHLP _ DSMENHLPw EPHLP1 n EPHLP2 EPHLP3 EPSHLP GTEFHLP MEDIHLP MEDIHLP2! STRTHLP .!