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IT_boy

Medicare claims transfer

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How do I send electronic claims transmission to Medicare or a clearing house like eclaims. They require file format of HCFA print image or a NSF file. Does anyone know how to get these file formats out of Filemaker.

I believe that there is already Filemaker based software that can send an electronic claim to a clearhouse, but I just don't how they do it. Any ideas?

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That will depend to which companies you are sending the claims to. I have worked with electronic claims going to various clearing houses, and I don't remember any of them specifying a specific file format. I believe we send all claims in a .dat format, and the clearing houses have been able to read them with out any issues.

We use the Troi-File plugin to create these files.

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Schedula Professional at www.LifeSuccess.org auto-generates CMS-1500 Health Insurance Claim forms as text files that you can then submit to clearing houses. Everything is done in FileMaker Pro without any plug-ins required. Seems to work fine.

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The only foreseeable problem there is that he will most likely run into a problem with Medicare when they decide to change around the form, or decide that they want different information to be sent.

If he here just going through clearing houses this wouldn't be an issue.

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I would recommend sending to a Clearinghouse unless all of your volume is Medicaid or Medicare.

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Thanks for the help, I'm using a print map file, which is just a text file with properly spaced out text. The print map file has text spaced out so that it would properly line up with a cms 1500 form.

It looks like schedula would be a similar type solution.

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