ELECTRONIC DATA INTERCHANGE (EDI)
The Administrative Simplification Compliance Act (ASCA) requires that providers submit claims to Medicare electronically to be considered for payment, with a limited number of exceptions. If a provider meets one of the exceptions, the provider is waived for a period of two years.
Exceptions to this requirement, include:
•Small providers, defined as a physician, practitioner, or supplier with less than 10 full time equivalent employees
• Roster billers of Medicare covered mass immunizations
• Claims for payment under Medicare demonstration projects when information is required that cannot be submitted electronically
• Claims where Medicare is the tertiary payer to two (or more) primary payers , and
• Dental claims.
More EDI information is available on the WPS Medicare Website at http://www.wpsmedicare.com/part_b/business/edi_hipaa.shtml.
PC-ACE PRO 32 ELECTRONIC BILLING SOFTWARE
PC-Ace Pro32 is a free, stand-alone software package that creates a patient database and allows your office to electronically submit most WPS Medicare Part B claims electronically. PC-Ace has many built in features to lighten your office’s workload. The software provides you with the ability to enter patient information, claim information, procedure file information, and creates a summary report of the claims you submit electronically.
If you are interested in using PC-Ace Pro-32 in your office, visit the WPS Website at http://www.wpsic.com/edi/pcacepro32.shtml or call our Electronic Data Interchange (EDI) department at (866) 503-9670.