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AUTOMATING YOUR MEDICARE AND MEDICAID LOGS
If you are receiving your Medicare and Medicaid remittances electronically you should be able to create your Medicare/Medicaid logs electronically, as opposed to manual data entry.
Software tools you will need:
- RAPrint – Medicare Remittance Print Software
- RAMedicaid – Medicaid Remittance Print Software
- RACombine – Utility Software to combine multiple remittance files into one file
- Monarch – Data Extraction Software
- Access – Database Software
RACombine Software
- Using RACombine, create one large master file containing a fiscal years with of remittance files.
RAPrint & RAMedicaid Software
- Using either RAPrint or RAMedicaid open the master file you created using RACombine. Select the report option "All Claims" and the output option "Print to File". Click OK. The software will ask you to name your file. The output is a ".TXT" file on your hard drive that is a mirror image of the printed Remittance Report.
Monarch Software
- Using Monarch, open the xxxxx.txt file you created with RAPrint or RAMedicaid. To do this you will need to create a "Monarch Model" which identifies the data you want to extract from the report. You only need to create a model one time. Thereafter you will simply open the model and it will extract the data you desire for your logs. You will then export the extracted log data to an Excel file. You now have your log in Excel format.
Access Software
- Import the Medicare and Medicaid logs into an Access database. Write a query that will compare the two Excel files and create a third file which has all Medicaid claims that matched up with a Medicare claim. You have just created your Medicare/Medicaid Bad Debt Log.
How much time does it take?
- The biggest amount of time will be in the combining of remittance files. If you are combining a whole year of Medicare files it will take you approximately 4-6 hours. (AP Associates is working on updating the RACombine software so that this process should only take 5-15 minutes).
- Creating the .TXT files using RAPrint and RAMedicaid will take approximately 10 minutes.
- Creating Monarch models is a onetime project of approximately 1-2 hours. Once you have created a model you don’t have to do it again.
- Creating an Access query takes approximately 5 minutes.
- Once you have accomplished the initial setup as described above, you can create any type of log you could desire in just seconds. The possibilities are endless. For example you might want to have a log for outpatient lab claims/charges; you might want to have a log for inpatient Part B only claims; you might want to have a log of denied outpatient charges; and the list goes on.
- The best part is that you know your logs are accurate because you are using original data from your electronic remittance files from the Medicare and Medicaid intermediaries
Contact AP Associates for more details.
AP Associates
504 Woodfield Drive
Asheville, NC 28803
(828) 296-1408
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software summaries in printable PDF format.
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