WINASAP5010 Quick Reference Guide for
Contents
1. Sex Last Name First Name Middle Name Initial M Provider Information Biling Provider Pay to Address Rendering Provider Taxonomy Code Signature on Files No Yes Pay to Plan z Referring Provider 1f Referring Provider 2 Supervising Provider X Claim Data mHealth Care Diagnosis Codes Anesthesia Related Procedure Condition Information Anesthesia Related Diaanosis tl Procedure Code 1 Condition Code List Principal p Condition Codes Diagnosis z Anesthesia Related Procedure Code 2 Other Diagnosis Codes Place of Service v Claim Frequency All tera e AE E EA E Type Code Next Page Save Cancel WINASAP5010 Quick Reference for BrickStreet Mutual Insurance Claim Types Under Claim Codes choose Workers Compensation Health for the Claim Filing Indicator WINASAP5010 BRICKSTREET MUTUAL INSURANCE Professional Claim Data SEE WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 19 Claim Types Under Claim Information click Related Causes Info to enter the Accident Date for the Date of Injury File Reference Claims Tools Window Help Claim Data Claim Codes Claim Information Claim Line Items m Claim Informatio Additional Claim Level Informatio Ambulance Transport Info Other Subscriber Info Claim Note2. Xerox Xerox EDI Direct Electronic Claims Acquisition Services WINASAP5010 Quick Reference Guide BrickStreet Mutual Insurance This document was developed for the BrickStreet Mutual Insurance provider community It is intended to provide download and setup instructions for WINASAP5010 a claim creation and submission software program Updated 06 07 2012 2012 Xerox Corporation All rights reserved XEROX and XEROX and Design are trademarks of the Xerox Corporation in the United States and or other countries Other company trademarks are also acknowledged Table of Contents j ie 0 o gk og i 6 Aenean ee ee a ae ea ee en Onn rE 1 WINASAP5010 Minimum Requirements uuu eesesesesesesesesesesesesesesescseseseseseseers 2 Converting WINASAP2003 Database to WINASAP5010 Database 3 Downiodding WINASAP S0 TU Bemeneeseen seme nett n eretetiertee etter earersra ar 3 Mstan WINASAPSO TO Seen en eee ee Seer nen nee en en ar E A ARIAN 6 Setting Up Trading Partner Information ccoseccvecctsceconcsexosevarsrsrocavescasnstsestonssesearasss 11 Setting up Reference Tables Reet onsen en nee nee en ne oe ene eon ee tO 13 Setting up Provider Data nn so0000000000000500000500ss0ossesseoseesseonsesseesseesseoseesseonsesseossessees 14 Setting up Patient td eeeeececenescersceneseeeessrweenncaes 16 Quick Tips for Using Vy IN ASAP BOT 0 ccscccscccsccccectcenscarsconacopscnpncnpscentenniereusnceaccetass 17 Specific Claim I
3. Spinal Manipulation Info Claim Price Reprice Information Supplemental Info Contract Info i i EPSDT Info Service Facility Info File Info Vision Info Miscellaneous Dates Next Page Previous Page Save Cancel Related Causes Codes a eae eee eevee a Required if above code ts Auto Accident Accident Country Code Accident Date if za Delete Data OF Cancel WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 20 Claim Types Institutional Claim UB92 Enter Date of Injury under Occurrence Codes Institutional Claim Data Claim Data Claim Codes Claim Line Items Frocedure Code Principal Procedure Principal Procedure Principal Procedure ra Code Qualifier Ei Date EE EA Other Proce Diagnosis Codes Principal Diagnosis Code Qualifier Occurrence Codes Other Diagn Admitting Date Diagnosis Code 1 13 i Qualifier l oad JIII Additional Claim Codes l on Assignment or Plan Part Be w Py Release of Int om Jd TH Delay T Claim Filing THE Ih Patient Heaton Oecurence Cr a Ph lil Value C aim Pricing Repr ea ho Additional Claim Informat ma Di Te NN RRR ESE EES NN RRRA UE TE ESTEE Patient Responsibility o Other Rete Amount Tl T EPSO Nest Page Previous Page jave WINASAP5010 Quick Reference for BrickStreet
4. Agreement If you choose No Setup Will close To install Winasap5010 vou must accept this agreement Back Y No 6 The User Information window will display next Enter your name and the name of your company Once this information is entered click Next User Information Please enter your name and the name of the company for whom wou work WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 7 Installing WINASAP2003 7 The Choose Destination Location window will display WINASAP5010 indicates where its program files will be installed Click the Next button Choose Destination Location Setup will ingtall Winaeap501 in the following folder To install to this folder click Next To install to a different folder click Browse and select another folder You can choose not to install WinasapS010 by clicking Cancel to eit Setup Destination Folder C Program Files ACS 5010 Browse Cancel 8 The Start Copying Files window follows indicating the current settings you have chosen so far during the installation Click the Next button Start Copying Files Setup has enough information to start copying the program files IF You want to review or change any settings click Back IF you are satished with the settings click Next to begin copying files Current Settings Setup Type Complete Application Directory C Program Files 405 44 5010 Database Directory C Program Fil
5. In box select Desktop from the drop down menu click Save After the file has completed downloading you may close your Internet connection Double click the file named Winasap5010_v101P exe located on your Windows Desktop and follow the on screen installation instructions WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 5 Installing WINASAP5010 Installing WINASAP5010 The installation and setup of WINASAP5010 is an easy two step process 1 Install the WINASAP5010 software on your PC 2 Start WINASAP5010 and set up your Trading Partner and Reference tables 3 When the first Welcome Window displays click the Continue button Winasap5010 Welcome ACS EDI GATEWAY INC Welcome to WIN ASAPSOIO Installation To install the software follow the installation prompts When completed lamch the software and enter 45 4 FP for the passarord Be sare you have at least 20 megabytes of free die space If yo have any problems dming the metallation process please contact the EDI Helpdesk EDI Helpdesk k InstallShield Welcome Welcome to the WinasapS01 0 Setup program This program ill install WwinasapS01 0 on your computer lk is strongly recommended that you exit all Windows programs before running this Setup program Click Cancel to quit Setup and then close any programs you have running Click Hest to continue with the Setup program WARNING This program i protected by copyright
6. Mutual Insurance 21 Claim Types Dental Claim Enter the Date of Injury under the Accident Date You will also be prompted to fill in the related causes info choose other accident and click ok Enter the tooth number under Tooth Status Information Dental Claim Data Claim Data Claim Information Claim Line Items Claim Information Release of Information Code Special Program Indicator Delay Reason Code Claim Filing Indicator Code Accident Date i z Repricer Received Date e E Date of Service i Patient Amount Paid ter st rr ae Sasa Predeterrnination of Benefits Indicator Claim Original lr Benefits Assignment Feference H Certification Indicator Additional Claim Level Information Related Causes Info Semice Facility Info Fredetermination Identification Contract Info Claim Notes Supplemental Info Tooth Status Info Referral Prior Authorization a Tooth Status Information Repriced Claim Tooth Humber Tooth Status Code First Erevious Next ok Cancel WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 22 Transmitting Claims Receiving Responses Transmitting Claims Receiving Responses This section will explain how to send claims electronically once they have been keyed 1 Select Tools Send Claim File WINKS APOSOUTO BRILKS IH MU TUA dS RAT le Reference Claims MEAE Window Help Send Claim File R
7. ASAP2003 files to WINASAP5010 system and vice versa Fill the necessary fields and then click the Save button to ensure that the values entered are compliant Please refer to page 11 of this guide for further information on setting up your Trading Partner Information Provider Data there are several changes and corrections in this section The biggest change which is essential is the change in the Secondary Identification information There is a new Identification Type Provider Tax Identification Number which is required and needs to be entered first Some Identification Types were also deleted which would show as blanks in 5010 The resolution is to delete their respective Identification Number or update them with their corresponding new Identification Types from the drop down menu Click the Save button to ensure that the values entered are 5010 compliant Please refer to page 14 of this guide for further information on the Provider Data table Patient Data new fields such as Property and Casualty Information can be seen in both the Patient Data and Insured s Data tabs these fields are situational so leave them blank if no information is available or if your claim is not a Property and Casualty Claim In addition there is a new button named Payer Secondary ID in the Insured s Data tab on the bottom right The Payer Secondary ID fields are classified situational not required fields Click the Save button to ensure that the values en
8. Patient ID Patient Relationship Self to Insured E nsured s Primary ID Entity Type Person Insured s Group or Plan Name Organization Name Insured s Group or Policy H m ae a Property and Casualty Information Tp fo Telephone tt fC f iat and Casual Payer Information 7 Payer Name BRICKSTREET MUTUALINSURANCE Paper Primary ID zos 0 PeyerAddess at Responsibly 7 Address cont Insurance Type City Payer Secondary ID State Y Zip Patient Data Save Listing 0 of 0 4 Click on the Save button WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 16 Quick Tips for Using WINASAP5010 Quick Tips for Using WINASAP5010 e Make sure you enter all providers and patients that you are submitting claims for in the Reference Section of the software first completing all the information including the address e Use the Tab key or the Enter key to advance to the next field when you are filling in any screen Reference or Claims e Do not use decimals or add extra zeros to procedure or diagnosis codes e TheF5 key is a quick key for adding the current date in all date fields e For faster data entry go to the Reference Menu first located in the upper left corner and fill out your applicable codes commonly used in your claims submission Example If you use the same group of procedure codes repeatedly enter the codes int
9. Secondary Information You must enter your 11 digit BrickStreet Commercial ID and select Provider Commercial Number Dental providers only when entering your UPIN please select Dentist License Number and then put in your UPIN WINASAP5010 BRICKSTREET MUTUAL INSURANCE File Reference Claims Tools Window Help r Provider List ID Type ID Ni Provider Data Provider Data Secondary Identification Identification Type Provider Commercial Number T Identification Number Payer ID Identification Type 7 Identification Number pooo Payer ID Identification Type igi Cae Identification Number Payer ID Identification Type Identification Number Po Payer ID Poo Identification Type Identification Number Payer ID Identification Type Identification Number Payer ID Listing 0 of 0 Identification Type 7 Identification Number Poo Payer ID oOo O O Prev Page Save Cancel 8 Click on the Save button WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 15 Setting up Patient Data Setting up Patient Data 1 From the WINASAP5010 Main Menu bar select the Reference option 2 Select the Patient option This will open the Patient List window Click on the Add button This will open the Patient Data window New information has been added to this screen such as the Property and Casualty Informat
10. actually see the file but it will change the status of your claims to either accepted or rejected If they are rejected contact the Xerox EDI Support Unit for assistance WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 25
11. at WINASAP trading partners perform the standard database conversion from WINASAP2003 to WINASAP5010 The database structures are different between the two software applications and may cause patient provider or claim data to be converted improperly If you choose to perform the database conversion refer to section 727 Converting WINASAP2003 db to WINASAP5070 db AND SECTION 12 7 1 Notes in Using Converted WINASAP2003 db on WINASAP5070 After downloading the WINASAP5010 software please follow the below steps to perform the conversion correctly Note Don t use the Restore Database of WINASAP5010 when converting the database from WINASAP2003 WINASAP5010 is unable to read the restored database Converting WINASAP2003 db to WINASAP5010 database WINASAP5010 allows users from WINASAP2003 to convert all the reference table information such as claim patient and provider After the conversion it will still be necessary to open each claim patient and provider record in WINASAP5010 to enter any additional information now required by HIPAA since this information either did not exist or was not required in WINASAP2003 The information that will have to be added is listed below e Additional Claim Information that will need to be added to each record converted from WINASAP5010 e Additional Patient Information that will need to be added to each record converted from WINASAP5010 e Additional Provider Information that will need to
12. be added to each record converted from WINASAP5010 Steps to perform the correct database conversion 1 Click on the Windows Start button 2 Select Programs Highlight WINASAP5010 then select Convert WINASAP2003 files to WINASAP5010 3 Click the convert button This will now copy the database of WINASAP2003 and then convert it to a format which is usable in WINASAP5010 Note WINASAP2003 should also be installed in the same machine since the converter would copy its database then convert it to WINASAP5010 format 4 Once the conversion is complete open WINASAP5010 and verify that your data is there Then you will need to go into each patient and provider record and add any additional required information as explained above WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 3 Converting WINASAP2003 database to WINASAP5010 Database Required Review by WINASAP5010 Users WINASAP users will be required to review the following WINASAP5010 sections due to the updated database structure from WINASAP2003 to WINASAP5010 Some changes in the database are new columns increased length and deleted values of the fields qualifiers This will assist the WINASAP5010 user to submit their 5010 files successfully The sections to review are listed below Trading Partner Information the information from WINASAP2003 in this Section was designed not to be copied to WINASAP5010 to ensure that the users would not accidentally transmit WIN
13. drop down list box This is a required field e Organization Name if non person entity selected or Last Name First Name if person selected This is a required field 5 Inthe Contact Information section complete the following fields Contact Name Telephone Fax Email 6 Inthe Additional Contact Information section complete the following fields if different from the above contact information Contact Name Telephone Fax Email WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 11 Setting Up Trading Partner Information 7 Inthe WINASAP5010 Communications section complete the following fields NOTE In the Host Telephone field enter Xerox EDI Direct data telephone number as follows 18503857455 If you must dial 9 to access an outside line enter the telephone number as 9 18503857455 The comma causes a one second pause You MUST enter the comma between the 9 and the first digit of the telephone number If your phone line has the call waiting feature disable it Refer to your local telephone book for instructions The following is an example of a number with call waiting disabled 70 9 18503857455 Please refer to your logon sheet for your specific submission phone number If your office has a long distance access code and you are unsure where to enter that number in this field please call the Xerox EDI Support Unit In the User ID field enter your 9 digit user ID and press lt TAB gt In
14. eceive Response File Build Nursing Facility Claims Reports Backup Database Restore Database Repair Claim Provider Data Update Reference Files Purge Claims Security 2 Then select Send Keyed Claims choose production and click Send WINASAP5010 BRICKSTREET MUTUAL INSURANCE Aggy Fie Reference Claims Tools Window Help Send Claims Submission Claim Status Selection C Send REJECTED Claims Claims That Have Been Billed But Rejected C Send ERRORED Claims Claims That Have Been Billed But Errored C Select by Claim Type PLEASE NOTE Nursing Facility Claims will be generated by selecting Institutional send areal f et WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 23 Transmitting Claims Receiving Responses 3 The following screen will appear click Ok if the number of claims to be sent is correct Send Claims Ioj x Submission Claim Status Selecto i Send KEYED Claims Claims That Have Not Been Billed Send REJECTED Claims Claims That Have Been Billed But Rejected Send ERRORED Claims Claims That Have Been Billed But Errored Submission Tune Selertin x 4 i System Message x Production 1 claims will be generated Do you wish to proceed f Select by Claim Type i Cancel PLEASE NOTE Nursing Facility Claims will be generated by selecting Institutional Test Submission SelectAll DeselectAll 4 WINASAP5010 w
15. es ACS Yw 501 O4db User Information EDI USER ACS 4 Serax Company Cancel WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 8 Installing WINASAP2003 9 WINASAPS5010 will begin copying its files to your hard drive sd Winasap5010 Setup Version 5 03 Winasap5010 Setup Version 5 03 c program files acs w501 O uninst dll einen 32 gt T LY gt 10 If you chose to restart your computer or you did not get the restart window you will now see the option to Launch the program If you place a checkmark in this box and click Finish it will start WINASAP5010 If you chose to launch the program after you clicked Finish go to Step 17 otherwise go to Step 13 setup Complete Setup has finished installing Winasap501 0 on your computer Setup can launch WinasapS01 0 by choosing the option below and clicking finish Click Finish to complete Setup lt Back 11 Click the Finish button WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 9 Installing WINASAP2003 12 When WINASAP5010 opens enter asap as the password for the ADMIN user ID click OK and then select the payer you will be submitting claims to This will become the default payer Note If you did not select Yes Launch the program file then follow these steps to open WINASAP5010 13 Click on the Windows Start button and select Programs 14 In the User ID field select the user name from the dro
16. ication tab Provider Data Provider Data Secondary Identification Provider Identification NPI Number Provider Taxonomy Code Provider Name Provider ddress Entity Type Address FS State n Fin Code Billing and Service Facility p ode Provider Zip MUST be 9 digits Provider T ax Identification Number ID Type l l Contact Information Additional ate Social Security Number Contact Name Contact Name Telephone I Ext Telephone I Ext Fax tt e Fax H K E mail E mail Next Page Save Cancel In the Provider Address section complete the following fields Address Enter the provider s physical address and press lt TAB gt Address con t City Enter the name of the city in which the provider s practice is located and press lt TAB gt State Use the drop down list box to select the state in which the provider is located and press lt TAB e Zip Code Enter the postal zip code for the provider s office address and press lt TAB gt In the Contact Information section complete the following fields e Contact Name e Telephone e Fax e Email In the Additional Contact Information section complete the following fields only if different than the above contact information Contact Name Telephone Fax Email WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 14 Setting Up Provider Data 7 Click the Next Page button to enter
17. ill generate the claims and then dial the modem to send them You will see a confirmation report appear just as it did after WINASAP2003 sent claims WINASAP5010 stores the last 50 confirmation reports in the reports section Send Claims l Ioj x Submission Claim Status Selecto f Send KEYED Claims Claims That Have Not Been Billed Send REJECTED Claims Claims That Have Been Billed But Rejected Send ERRORED Claims Claims That Have Been Billed But Errored Submission Tune Selectin x 7 i system Sa x f Production 1 claims will be generated Do vou wish ko proceed Select by Claim Type F I W Cancel PLEASE NOTE Nursing Facility Claims will be generated by selecting Institutional EJEA Test Submission Select All Deselect 4ll WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 24 Transmitting Claims Receiving Responses 5 After at least 2 hours go back into WINASAP5010 and receive your response file This will let you know if the file was accepted or rejected 6 Select Tools Receive Response File WINASAP 5010 BRICKSTREET MUTUAL INSURANCE Hal MeL i al e m m LL lip L laii Ne Tools Y Send Claim File Receive Response File Build Nursing Facility Claims Reports Backup Database Restore Database Repair Claim Provider Data Update Reference Files Purge Claims Security 7 Click Receive Receive Response File 8 You will not
18. ion WINASAP5010 BRICKSTREET MUTUAL INSURANCE File Reference Claims Tools Window Help ta Err n a a Y a Y Patient List M aox Patient ID Sex_ Patient Account No Patient Name 0 O OOO OOOO O Date of Birth Property and Casualty Info Tel Patient Data DER Patient Data Insured s Data Patient Identification Patient ID Patient Account Patient Name and Demographic Information Last Name Date of Birth i A Medicare Recipient D First Name Date of Death 7 7 A Middle Name ini Initial Weight Suffix Sex 7 Property and Casualty Information oa m X O o Property and TCS Name Telephone Ext Casualty Claim Property and Casualty Property and Casualty o Patient Code Patient Identifier Patient Address Information Address Address con t Insurance Cancel Listing 0 of 0 3 Click the Next Page button to enter Insurance Information Choose Self under the Insured Information Choose Primary under the Payer Responsibility Sequence Code Additionally there is a new button named Payer Secondary ID under this tab WINASAP5010 BRICKSTREET MUTUAL INSURANCE File Reference Claims Tools Window Help gt _ Patient List PatientID Sex Patient AccountNo PatientName 0 te of Birth Property and Casualty Info Tel Patient Data DE Patient Data Insured s Data Insured s Information _
19. law and International treaties Unauthorized reproduction or distribution of this program or any portion of it may result in severe civil and criminal penalties and Will be prosecuted to the masimum extent possible under law WINASAP5010 Quick Reference for BrickStreet Mutual Insurance Installing WINASAP2003 5 The Software License Agreement window displays next Read through the agreement and click yes to accept the terms of the agreement and continue installing WINASAP5010 If no is clicked the install program will terminate Software License Agreement Please read the following License Agreement Press the PAGE DOWN key to see the rest of the agreement WIN AS APSO User License Agreement WHEREAS ACS has developed WINASAPSOIO an electronic billing software package that enables medical providers to file claims with ACS hereinatter WINASAPSOO and WHEREAS Provider wishes to use amp license WINASAP5O10 for its business use NOW THEREFORE in consideration of the mutual promises and covenants contained herein and other good and valuable consideration the receipt and sufficiency of which t hereby acknowledged the parties hereto agree to as follows 1 License ACS hereby grants and Provider hereby accepts a non transferable non exclusive license to use WINASAPSOTO solely for its own business use in electronically submitting medical claims to ACS z Do you accept all the terms of the preceding License
20. ner Information screen must be completed before you can successfully submit claims This is a required step In the event that your name address telephone numbers or identification numbers change you can perform these procedures again to update your Trading Partner data 1 From the WINASAP5010 Main Menu bar select the File option 2 Select the Trading Partner option This will open the Trading Partner window WINASAP5010 BRICKSTREET MUTUAL INSURANCE File Reference Claims Tools Window Help Trading Partner Information Trading Partner Identification Primary Identification Secondary Identification Trading Partner Name Contact Information Contact Name Entity Type Telephone f J FAX ji Email Additional Contact Information WINASAP5010 Communications Host Telephone TE User Name Cancel 3 Inthe Trading Partner Identification section complete the following field e Primary Identification field enter your 5 or 6 digit Trading Partner ID number assigned to you by Xerox EDI Direct and press lt TAB gt This is a required field e Secondary Identification field enter your 5 or 6 digit Trading Partner ID number assigned to you by Xerox EDI Direct and press lt TAB gt This is a required field 4 Inthe Trading Partner Name section complete the following fields e Entity Type Select the appropriate choice from the
21. nformation e esesseessesssesseessesseessesseessesseesseessesseessessersseessesseessesseess 18 Professional Claim HCFA1 500 occa cccocccesscesectste steer auseeceeienieaseddiearnenavaniaidenduiedavaetev ee 18 Institutional Claim UBI 2 nssanrpsnea eE 21 Dental EAn E E E E E ern ter nee ere 22 Transmitting Claims Receiving RESPONSES cessscsesesesscsesesesesesseseseseseeeeesees 23 The contents of this manual and the associated WINASAP5010 software are the property of Xerox Any reproduction in whole or in part is strictly prohibited This software may be used only for submission of claims through Xerox WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 1 WINASAP5010 Minimum Requirements WINASAP5010 Minimum Requirements To use WINASAP5010 your personal computer must meet the following minimum requirements e Windows 98 Second Edition Windows NT Windows 2000 Service pack 3 or higher and Windows XP Professional Operating Systems Window XP Home may cause some issues with installing Pentium Processor CD ROM Drive 25 megabytes of free disk space 128 megabytes of RAM Monitor resolutions of 800 x 600 pixels Hayes compatible 9600 baud asynchronous modem Telephone connectivity WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 2 Converting WINASAP2003 Database to WINASAP5010 Database Converting WINASAP2003 Database to WINASAP5010 Database Please be advised it is not recommended th
22. o the Procedure Code Reference Screen and use the drop down menu on the claim form to select the code instead of data keying You can also use this process for other reference information such as patient data diagnosis codes etc e Dates earlier than 1960 1959 and before must be entered in MMDDCCYY format e g November 18 1945 11181945 If not WINASAP5010 will interpret the two digit date as being 2045 vs 1945 e To quickly select the appropriate date in a date field click the calendar button then double click the appropriate date If you no longer want to select a date press the spacebar to exit the calendar window pop up Free technical support is available from the Xerox EDI Support Unit WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 17 Claim Types Specific Claim Information This section will identify specific fields used by BrickStreet Insurance by claim type which need additional explanation Professional Claim HCFA1500 Choose 1 Original Admit through Discharge for Claim Frequency Code WINASAP5010 BRICKSTREET MUTUAL INSURANCE Sai File Reference Claims Tools Window Help Professional Claim Data Claim Data Claim Codes Claim Information Claim Line Items Claim or Encounter Chargeable gt Bill Date 2 iz User Batch User Claim Number Claim Status Keyed 7 Identifier Chargeable v Patient Information Patient ID Patient Account t Date of Birth
23. p down list box ADMIN is the initial default Winasap5010 Login User ID ADMIN Password tz Cancel 15 In the Password field enter your password asap is the initial default for the ADMIN USER ID 16 Click on the OK button 17 The Select Payer drop down box will appear Select the payer you will be submitting claims to Once you make this selection it will become your default payer You will not need to choose it each time Click on the OK button Open Payer Tou must select the appropriate Payer from the Payer list OK Select Payer KS y AL INSURANCE Cancel Show Payer Edita 18 The WINASAP5010 Desktop with the Main Menu Bar will display You are now ready to begin updating reference tables or entering claims Note WINASAP5010 has a default user ID of ADMIN and password of asap If you want to use the default user ID you may However if you want to establish different security levels for different users you may do so by following the procedures in the user manual WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 10 Setting Up Trading Partner Information Setting Up Trading Partner Information WINASAP5010 uses the information you enter in the Trading Partner Information window to uniquely identify your claim data and to provide Xerox EDI Direct with the information necessary to authorize and accept your claim transmissions Note The Trading Part
24. tered are 5010 compliant Please refer to page 16 of this guide for further information on the Patient Data and Insured Data tabs Claims Data Dental Claim Institutional Claim Nursing Facility Claim Nursing Facility Template and Professional Claim several fields and dropdown items were removed in WINASAP5010 There are some new fields which are required and should be entered first prior to sending the claim Note Do not copy any claims that were used in the WINASAP2003 software The WINASAP user is required to key any new claims in the WINASAP5010 to ensure that the entered values are 5010 compliant Click the Save button to ensure the values and fields are 5010 compliant Please refer to the Specific Claim Information starting on page 18 of this guide for further information on Claim Data WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 4 Downloading WINASAP5010 Downloading WINASAP5010 Go to http www acs inc com edidirect From the menu bar Claims Gateway gt WINASAP gt Software and Manuals On the WINASAP5010 Software and Manuals page click WINASAP5010 Version 1 01 A new window will open with a direct link to download the software Please proceed to download When the screen appears prompting you to Open this file from its current location or Save this file to disk choose Save this file to disk Then click OK A box will appear asking where you would like to save the file In the Save
25. the User Name field enter your User Name exactly as it appears on your logon form 8 Click on the Save button to record update your Trading Partner data WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 12 Setting Up Reference Tables Setting up Reference Tables Although some reference tables are optional they allow you to key claims faster Information from the reference tables is used by the system to automatically fill claim fields or to create drop down list boxes to help you select data field values In the following section you will find an example of setting up a reference table for Provider Data and Patient Data both of which are required m Reference Claims Tools Window Help Provider Patient Anesthesia Codes Condition Code Diagnosis Code External Cause of Injury Code Occurrence Code Patient s Reason For Visit Code Procedure Code Revenue Code Surgical Code Taxonomy Code Treatment Code Value Code Error Text Procedure Modifiers WINASAP5010 Quick Reference for BrickStreet Mutual Insurance 13 Setting Up Provider Data Setting up Provider Data From the WINASAP5010 Main Menu bar select the Reference option Select the Provider option This will open the Provider List window Click on the Add button This will open the Provider Data window You must select the HCFA National Provider ID Note You will now enter your EIN or SSN on this tab and not on the Secondary Identif
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