How to setup Medisoft Revenue Management for Change Healthcare

PREREQUISITS

On any workstation (including the server) that will use Revenue Management, adjust the following settings. You can search for the following settings via the Task Bar:

DEP (Data Execution Prevention); Should be set to “Turn on DEP for essential Windows programs and services only”. You can find this setting by searching Windows for “Advanced System Settings”.
UAC (User Account Control); Should be set to the lowest setting, “Never Notify”.
*Note: You may need to login as “Administrator” to adjust this setting.

3. UAC (User Account Control); Should be set to the lowest setting, “Never Notify”.

*Note: You may need to login as “Administrator” to adjust this setting.

This setting may be modified via the registry, however this is only recommended for Advanced Users, if you are unfamiliar with modifying the registry, please call support for help.

HKLM\SOFTWARE\Microsoft\Windows\CurrentVersion\Policies\System
Set “EnableLUA” = “0”

PRACTICE MANAGEMENT SETUP

Make sure logins are setup in the Practice Management System (“PMS”) database as Revenue Management requires a login.
Verify information needed to bill claims (like Practice information, Providers, IDs, etc.) is setup.
Go to Lists, then EDI Receivers, New and enter a code and name.

4. Go to Lists, then Insurance, then Carriers and edit. On the EDI/Eligibility tab select CHNG as EDI Receiver enter the appropriate 4-digit Payer ID (use “CHC Payer ID). The Change Healthcare’s payer search can currently be found at: https://connectcenter.changehealthcare.com/#/site/payers

*Optionally: If you’ve also signed up for Eligibility Verification, now would be a good time to
enter that ID (use “Eligibility ID”) as well.

*Note: The “9999” is just an example, use the appropriate ID from Change Healthcare’s Payer List.
*Note: Some payers may require additional paperwork (Payer Agreement), see above link.

SERVER SETUP

1. Create a folder called RMData in the Medidata folder.

2. In the Windows Start-menu, go to “Programs” or “All Programs”, then “Revenue Management”. Select “Check for Updates”. If the PMS is still open and updates are found, close the PMS. Complete the update process if updates are found, or click Close if none are found.

3. Go to Activities, then Revenue Management, then Revenue Management

4. Click Create, then browse to and select the “RMData” folder, then click OK.

5. Browse to and select the “RMData” folder, then click “OK”.

6. If the “DB List Upgrade” window appears, click OK, otherwise continue on to the next step.

7. If the “Revenue Management Update” window appears, click Next then Close (since the updater was run in “Step 2”, no updates should be found).

8. On the “Add Practice” window, select the practice you’re trying to setup, then click OK.

9. On the “Database Upgrade” window, click OK

10. On the “Configure?” window, click OK.

11. On the “Connection Wizard” window, click Next.

12. Enter a Login Name and Password.

13. Select a “Connection” that begins with “ChangeHealthcare 2521 MS General” and ends with the value that best describes the type of claims you send: General (used in most cases), or… Ambulance, DME, ESRD, Rehab, Rural.

14. Select the receiver setup for Change Healthcare and click next (Practice Management Setup; “Step 3”).

15. Complete the following fields on the “Additional Receiver Information” window (it is not necessary to complete the “Secondary Contact Information”).

Group Practice: Select/check if this is a Group Practice (one that has a Group/Practice NPI).
Primary Contact; Name: Enter a first and last name.
Primary Contact; Type: Select “TE/Telephone”.
Primary Contact; Number: Enter the contact telephone number.
ISA/GS Submitter ID: Enter your Change Healthcare assigned ID (“p” + “Submitter ID”).
1000A Submitter Name: This will default to the practice name, change if desired.
1000A Submitter ID: Enter the “Billing ID” + “Submitter ID”.
Taxonomy: Leave blank
User ID: Enter your Change Healthcare assigned ID (“p” + “Submitter ID”).
Password: Enter your Change Healthcare assigned password.
Communication Session: Leave default; “CHCL”.

16. Click Next, then click Next on the following screen (“Configuring Receivers”).

17. On the “Edit Receivers” window, find the line for the EDI Receiver being setup, and make changes to the fields as necessary (click outside the fields to return to the main grid):

Check GroupPractice or UseBilling Service if this applies to you. Scroll for additional settings.

18. ClaimNumberFormat: Select desired option (click in field for options).
SupressLegacy: It is recommended to check this option (this prevents non-NPI/EIN IDs).
SendDrugLoop: If NDC information may be transmitted, select this option.

19. For “EntityType” select Non-Person for Group, or Person for an Individual.

20. Click “Claim Status” to view additional settings.

21. Click “Outbound Claims” to verify iGuide settings.

22. For the IGuide setting Select “Outbound Claims (837P MS25 Claim – Standard)” for Professional Claims or (837I MS25 5010 Claim – General UB04) for Institutional Claims.

23. Click Finish when done.

24. Highlight the practice and then click “Select”.

25. The Revenue Management main window should open. If the “Claim Editor Database Update” window also appears, close Revenue Management, then click Next on the update window. Click Next, then Start. When the update finishes, click Finish. Open Revenue Management again.

26. Click “Next” and then “Start” and the update process will begin.

27. Wait for the update process to complete.

28. If Revenue Management is still open click close it and retry.

29. When the “Claim Editor Database Path” window appears click start.

30. When the “Update Successful” message appears, click “Finish”.

31. Go to “Activities” then “Revenue Management” then Revenue Management.

32. On the “Install?” window verify now else is in Revenue Management and then click “Yes”.

33. On the “Install Claims Editor Update” window click “OK”.

34. When “The Claims Editor update has been installed” message appears, click “OK”.

35. Go to “Activities” then “Revenue Management” then Revenue Management.

36. Go to “Configure” then “Preferences”.

37. Select the “Revenue Management” tab, then select the “Remit Posting Options” sub-tab. Select default posting code for Adjustment, Withhold, Deductible, and Take Back.

38. Select the Claims Editor tab and click Next.

39. Click Next, then select any state(s) where services are performed.

40. Click Next, then select any Payers to which claims may be sent. If none of the listed payers apply, you do still have to select at least one.

41. Click Next, then select any services the practice performs. Optionally; Select to Suppress Dx Warnings.

42 Click Next, then choose a CCI Edit Type and Global Periods Option.

43. Click Next, then Finish, then Save.

44. Go back to Configure, then Preferences.

45. Select the Assign Posting Codes tab. Set your desired “Insurance Adjustment” code under the CHCL column (and under any other EDI receivers if you maybe posting remittance for those insurances), next to “42” and “45”. These correspond to “CO42” and “CO45”.

*Note: These are just examples, your claim types, insurance carriers, and code preferences will determine
what codes should be set, and the code is your preference.

46. Optionally; Set any other adjustment reason code numbers to the desired “Insurance Adjustment” Code, under the appropriate receiver column. For example, if you need to post an “OA23”, set the desired “Insurance Adjustment” code, next to “23”, under the CHCL column

If you have multiple “EDI Receivers” (setup for different insurances), you can set them to use a different “Insurance Adjustment” codes:

If you have multiple “EDI Receivers” (setup for different insurances), and you want one or more of them to use a different “Insurance Adjustment” code, that can be setup as well: