Instructions for receiving New York State Medicaid eMedNY eXchange electronic remittance advices electronically:

 

May 5, 2005

Revised: August 10, 2005

 

Dear client:

We are happy to inform you that all New York State Nursing Homes that invoice Medicaid using eMedNY eXchange (Phase II HIPAA 835) can now download Medicaid remittances for use by the CHARTS Post Room and Board Receipts program, RBRECEPT [AR, 4, 2].

The new CHARTS software that is required to process these files is included with this update (PATCH017).

Please be aware of the following drawback when using electronic remittances from CSC: The error messages supplied by CSC are more generic and contain less detail. For example, if the resident's birth-date on the claim is incorrect you will get a generic message, "Claim Lacks Information."

Instructions for using this new feature follow:

 


Step 1a - Applying:

Complete the "Request for Electronic Remittance Advice" form and send it to Computer Sciences.

NOTE: For  "Chosen Method of Remittance Retrieval" check eXchange.

Step 1b - Set-up

Create a directory (or directories) in which to store the cash receipt files you will download.

  If you have only one Nursing Home facility do the following:
  On the drive that contains CHARTS (usually R), under directory RHS\Volb create a directory called CASH.
   
  If you have multiple facilities create separate directories for each facility as follows:
  Each directory name should begin with the word CASH followed by a facility designator up to 4 characters. For example, if you have two facilities name Pineview and Oakview create two directories, called CASHPINE and CASHOAK.
  Create the new directories on the drive that contains CHARTS (usually R), under directory RHS\Volb.

For each facility create a pointer in CHARTS to the directory (or directories) that you created.

  In CHARTS, at ENTER MENU NUMBER type ATF and press ENTER. Type 18 ENTER, and 2 ENTER.
  At Main Key type CASH   At Secondary Key type CASH. (i.e., 'CASH' followed by a '.') and press ENTER.
  At Description type CASH
  At File Name type FILE
  At Library type CASH (For multiple facilities type the directory name you specified above.)
  At Number of Bills type 300
  At Enter (F) To File (I) To Ignore Type F and Press ENTER.

 Step 2 - Downloading - Overview:

Please note that Medicaid provides two remittance files:

One file contains all Paid and Denied Claims - HIPAA 835 Format, and the other contains all Pending Claims - Supplementary File Format.

The eMedNY files to load and the CHARTS programs to run are summarized below:

eMedNY eXchange

 

CHARTS

Claim Types File Name Save As... Program Name Path
Paid and Denied R...... .x12 PYYMMDD.dat HCRMA835 Cash Receipt Medicaid [AR, 4, 10]
Pended R..... .SMD SYYMMDD.dat SUPL835 Supplementary Pended MA Claims [AR, 4, 14]

See the following two pages for detailed instructions.


Step 2a - Downloading Paid and Denied Claims:

Go to www.eMedNY.org , and click on Login eXchange to log on.

In the 'in-box' find the file with the appropriate date and with a file name: R...835... .x12

Click on the file to download, and click Save. At Save as Type select All Files.

At File Name specify PYYMMDD.dat (where YY is the year, MM is the month and DD is the day of the date associated with the file you are downloading.)

At Save In specify the appropriate directory that you created in step 1b above (e.g., r:\rhs\volb\CASH or CASHXXXX).

On CHARTS run program HCRMA835, HIPAA Cash Receipt Medicaid, [AR, 4, 10]. NOTE: Do not run this program if you are in the middle of a Room and Board cash receipts, it will override your cash receipt entries.

The following screen appears:

                          HIPAA 835 - CASH RECEIPTS MEDICAID

Device No.: ▬▬▬ PC Filename: ▬▬▬▬▬▬▬▬▬▬▬▬

Disk File to  --> File : ________ in Library: ________ on Volume:        
Create or Use

Create Cash Receipts File : Y
Cash Receipts --> File : CRRB0038 in Library: WORKLIB_ on Volume: VOLR__
Temp File

Print Option: P

Device No. and the PC Filename should be left blank for NT/Novell/Windows systems.

Device No. and the PC Filename should be filled in for Unix platforms ONLY.

At "Disk File to  Create or Use --> File" type PYYMMDD  (where YY is the year, MM is the month and DD is the day, as specified above.)

At Create Cash Receipts File leave as initialized to Y. (This should be changed to N only if you wish to get a cash receipt listing from a file without processing it.)

Leave all other fields as initialized and press ENTER.

Run CHARTS program RBRECEPT, Post Room and Board Receipts [AR, 4, 2] to post the cash receipt records. On the Billing Type selection screen place an X alongside Medicaid and press ENTER. You will then be prompted with 'S' to Save or 'B' to Begin New File. Type 'S'. At this point you are ready to list and then post your cash receipts.

Be sure to review the printouts before posting.


Step 2b - Downloading Pended Claims:

Go to www.eMedNY.org , and click on Login eXchange to log on.

In the 'in-box' find the file with the appropriate date and with a file name: R..835s.... .SMD

(Verify that you have the correct file by opening it and finding your TSN and Provider number in the beginning of the file.)

Click on the file to download, and click Save. At Save as Type select All Files.

At File Name specify SYYMMDD.dat (where YY is the year, MM is the month and DD is the day of the date associated with the file you are downloading.)

At Save In specify the appropriate directory that you created in step 1b above (e.g., r:\rhs\volb\CASH or CASHXXXX).

On CHARTS run program SUPL835, Supplementary Pended MA Claims, [AR, 4, 14]. NOTE: Do not run this program if you are in the middle of a Room and Board cash receipts, it will override your cash receipt entries.

The following screen appears:

               SUPPLEMENTARY 835 DOWNLOAD - Medicaid NY Pended Claims

Device No.: ▬▬▬ PC Filename: ▬▬▬▬▬▬▬▬▬▬▬▬

Disk File to  --> File : ________ in Library: ________ on Volume:        
Create or Use

Create Cash Receipts File: N
Cash Receipts --> File : CRRB0038 in Library: WORKLIB_ on Volume: VOLR__
Temp File

Print Option: P

Device No. and the PC Filename should be left blank for NT/Novell/Windows systems.

Device No. and the PC Filename should be filled in for Unix platforms ONLY.

At "Disk File to Create or Use --> File" type SYYMMDD  (where YY is the year, MM is the month and DD is the day, as specified above.)

At Create Cash Receipt File the default is set to N, not to post any records, because little is gained by posting a zero cash receipt. Also, Claim Reference Numbers on Pended claims are meaningless. Leaving this set to N will give you a detailed listing of your Pended claims - without any postings.

Leave all other fields as initialized and press ENTER.

Run CHARTS program RBRECEPT, Post Room and Board Receipts [AR, 4, 2] to post the cash receipt records. On the Billing Type selection screen place an X alongside Medicaid and press ENTER. You will then be prompted with 'S' to Save or 'B' to Begin New File. Type 'S'. At this point you are ready to list and then post your cash receipts.

Be sure to review the printouts before posting.


If you have any additional questions please feel free to call client service at (718) 338-2400.

END