Summer 1995 Newsletter

Volume I Issue I ©1995

Inside this issue:

SuperQuick Advantage
Physician Advantage
CheX Eligibility Verification
Payor Review
Timely Tips
To "Q" You In
Client Spotlight

QuadaX merged with WHO ?!?

Just five short months ago, Quadax completed the tumultuous process of merging with our largest competitor in Cleveland . . . . . Billitron, Inc. Mergers are often painful to those involved, especially when the participants are companies that were once friendly competitors. Traditions, apparent differences, duplicity, and yes egos all tend to get in the way of the ideals that were so apparent when the process began.

Five months later we're very happy to report that the fit is like a glove! The professionalism demonstrated by all involved has allowed us to expand at a rate that no one could have predicted. Not only have we increased sales tremendously, but we're planning an office expansion in our Cleveland West facility and working on plans for new or relocated offices in Middleburg Heights, Youngstown, Dayton and Parkersburg, West Virginia..

We're very proud to announce and welcome to our Client family two very prestigious practices, Innova Medical Services, Inc. and the recently merged Bayless-Pathmark, Inc. Innova is a Cleveland based, multi-specialty group practice. Bayless-Pathmark is a 9 hospital based pathology practice in Northeast Ohio. Our ability to absorb these two giants was enhanced greatly by the additional practical and creative capacities afforded to us through the merger.

We are now a company over 250 strong. The development of our Healthcare Services Group, under the leadership of Kevin Ellison, has allowed us to sustain growth and continue to provide quality services while our Technical Services Group concentrates on the new challenges approaching healthcare in our part of the world.

Thanks to all who made it such a successful endeavor!

SUPERQUICK ADVANTAGE

New in '95

Good news!!!! Quadax has PC Networking for SuperQuick ADVANTAGE.

What does this mean to you? SuperQuick ADVANTAGE claims software can now be accessed by as many PCs as are available on the local area network. For example, if your office has 10 PCs on the network, all 10 can access SuperQuick claims.

Once you have the hardware for a local area network in place, all that is required is a 486 PC or better with a minimum of 15 MB RAM, a 10-20 MB free hard drive space - to act as a server - and SuperQuick Advantage along with Windows for Workgroups or Novell software. As for the other PCs on the network, they must have a 386 or better processor with a minimum of 8 MB RAM.

So, if you and your PC are ready to start accessing claims, call Jim McCauley or Brad Daugstrup at (216) 777-6300 for more information on this exciting new development.

Software Update

For those of you using the PC SuperQuick Advantage software, there is a feature that allows you to duplicate a claim. This feature is available to make split billing easier.

Note that on the claim selector screen the F6 key states Dup Claim. When you press this key, a prompt displays yes or no to duplicate the claim (highlighted with bar). Responding yes brings up a prompt - do you want to duplicate charges? So you have the option to duplicate the entire claim or all the claim data except the charge lines.

Are you confused? Need some SuperQuick Advantage questions answered??? Call Customer Service Support at (614) 882-1200 for a walk through of the feature.

Working Towards...

... Two additional SuperQuick features are now available on the PC Advantage software.

1. Change Payor
2. Force a claim
   

... In the past, these were only available through SuperQuick.

... In the near future, Quadax will be releasing a UB92 Advantage software version that will contain PC edits (currently edits reside on SuperQuick only).

... You will receive a notice by mail and a message will be posted on the SuperQuick Bulletin Board. Watch for this announcement!

System Availability

Just a reminder of the hours that the Quadax systems are available.

1. TRANSMISSION OF CLAIMS FROM THE HOSPITAL MAINFRAME:
   You can transmit your claims to Quadax Monday through Friday, 5am to 8pm. If you are sending more than one file, please remember to wait 15 to 30 minutes between transmissions.
2. SUPERQUICK
   SuperQuick hours are Monday through Saturday, 5am to 8pm and Sunday, 5am to 12 noon.
3. ADVANTAGE
   Claims that reside on your PC Advantage software can be worked on at anytime. However, downloading and uploading of claims to and from the PC Advantage software must occur during the SuperQuick hours given above in #2.

Retrieving Archived Claims

Quadax announced the retrieval feature in June, 1994, and we thought a review of the feature would be helpful to everyone.

All UB92 claims sent through the Quadax system can be retrieved and loaded into SuperQuick for additional review or action. Quadax automatically stores (archives) all UB92 claims that are electronically submitted through the Quadax clearinghouse. These claims can then be retrieved through the RETRIEVAL function of SuperQuick. This feature is item number "3" on the SuperQuick LOGON screen.

Claims are immediately retrieved into SuperQuick if the Date of Service (FROM DATE) is within 3 months prior to the current month. For example, claims with FROM DATES of October, November, December and January can be immediately retrieved up through the last day in January. Claims older than 3 months will be retrieved and loaded into SuperQuick over the weekend.

Inquire on Previous Requests

You can go back and check the status of previously retrieved claims at any time. From the CLAIM RETRIEVAL screen, simply enter the letter "I" for INQUIRE ON PREVIOUS REQUESTS. The system will then display a screen similar to that shown below in which all previous retrieval request are listed.

       CLAIMS RETRIEVAL INQUIRY SCREEN

PATIENT CONTROL   PATIENT         BILL          CLAIM   REQUEST  RETRIEVE  CNT    STAT
    NUMBER         NAME           TYPE   DOS    TYPE     DATE    DATE      RETR

   PB23596      PETERSON SHARON    111  012191   2A    940515    940521    O01    DONE
   GC93101      MCELHANEY PATRICK  111  940524   1A     940524   000000    001    PEND

NO MORE ENTRIES-PRESS RETURN TO GO TO MENU

This function is to the detailed document function in the WORK REPORTS section of SuperQuick; in that the on-screen listing shows the status of all retrieval requests.

The right-most column shows the current status of the claim requests. "DONE" indicates that the claim has been loaded into Super-Quick while "PEND" shows that the request has been received but that the claim is still in the retrieval stage. "NOT FOUND" indicates that no claims were found matching the entered criteria.

The CNT RETR column indicates the number of claims that were retrieved for a particular request. Note that the two columns that precede this information show both the date of the request and the actual date the claim(s) were loaded into SuperQuick. The first five columns display basic claim information.

Retrieval Tips

• If the patient account # doesn't match EXACTLY, THE CLAIM WILL NOT BE FOUND. If you can't retrieve the claim with the patient account #, leave the field blank and try to retrieve by patient last and first name.
• For claims with dates of service older than 3 months, ALWAYS ENTER "999999" AT THE PROMPT: enter from date "MMDDYY". This will Pend the claim so it can be retrieved over the weekend and be available on SuperQuick the following Monday.
• Only claims submitted to Quadax electronically are automatically available for retrieval. NON-ELECTRONIC claims (i.e., self-pays, commercials that are non-NEIC) can be captured for retrieval BUT a set up of miscellaneous claims is required ahead of time. Contact Quadax if you want to retrieve these types of claims. For more information on retrieval of archived claims, please call Customer Support at: (614) 882-1200.

PHYSICIAN ADVANTAGE

The latest version of Physician Advantage is now available! Version 2.12 contains the most up-to-date features and functions developed for Physician Advantage. This software enables a user to submit professional fee claims through a modem connection, then retrieve, correct and re-submit claims that fail the edits.

Some of the more notable features include: full networking capability for up to 6 users; HCFA 1500 screen formatting for entry and correction of claims; modem connect speeds of up to 14,400 bps; full feature editor for viewing or changing print-file data; on-line connection to Quadax for diagnostics/ troubleshooting.

'The list of carriers to which claims can be submitted contains the names of over 250 companies. As new carriers are added, users are notified through on-line messaging and a new listing is added to the client's system.

This software has been successfully interfaced with more than 40 common patient accounting software packages, resulting in the elimination of "double entry" of patient claims. Is your system capable of interfacing with Physician Advantage? Contact Durene Ursem at (216) 777-6300 to find out!

CHEX

We have Eligibility Verification!. A new service is now available through Quadax called CheX.

CheX is a self installable PC based software package which allows you to access up-to-the-minute eligibility information on patients that your practice has treated or will be treating. This information comes directly from the respective Third Parties.

CheX provides your practice with a uniform approach to accessing this information directly from your office. CheX has been designed to interface with all third parties making eligibility information available, so that your staff need only be trained on a single system. Today CheX can already provide you with eligibility access to the following carriers:

• Ohio Medicaid
• West Virginia Medicaid
• NEIC Carriers:
  • Aetna Cigna
  • John Hancock
  • Metlife
  • Pacificare
  • Prudential

Recognizing that this area of data processing is in its infancy, CheX was designed with the capability to be expanded to deal with more carriers as they make this information available. We expect many more to become available in the near future.

Brochures and demo diskettes are available - for more information give Durene Ursem a call at (216) 777-6300.

PAYOR REVIEW

Medicare On-Line System

Did you know that the PC and modem you use to send electronic claims to Quadax can also be used to communicate to Community Mutual Insurance Company's Medicare on-line system? Just call Customer Support at (614) 882-1200 and request a complimentary diskette and instructions.

CHAMPVA

Effective May 15, 1995 CHAMPVA claims may no longer be billed electronically. Champus has discontinued their practice of sending these claims on to the VA Center. After the 15th, the Quadax system will longer recognize this payor. You must bill them hard copy to:

CHAMPVA CENTER
P.O. Box 65024
Denver, CO 80206

You may also call Administar directly at (800) 962-2914

If you have any questions, please contact Quadax Customer support at (614) 882-1200.

Ohio Bureau of Workers' Compensation

Just a reminder that BWC will NOT accept Bill Types 115 or 135 as electronic submission.

Late charges bill types (115 and 135) must be mailed to BWC as hard copy submissions.

Community Mutual Blue Cross

Just a reminder, revenue code 760 (Treatment/Observation room) and 769 (Other Treatment/Observation room) are no longer valid codes for CMIC. Instead, use 761 (Treatment Room) and 762 (Observation Room).

Quadax edits were modified for General Motors claims. For claims with social security number (Block 60) that begin with alphas NGM. These claims will be edited for mammography screenings. When Physicians' Current Procedural Terminology (CPT®) code 76092 is reported, Revenue Code 403 is required. If CPT® code 76090 or 76091 is reported, Revenue Code 401 is required.

Medicare Radiology HCPCS

Medicare will not accept claims for radiology HCPCS codes that are not reported under one of the following revenue codes:

• 32X - Radiology- Diagnostic
• 33X - Radiology- Therapeutic
• 34X - Nuclear Medicine
• 35X - CT Scan
• 40X - Other Imaging Services
• 61X - MRI
  

New NEIC Claim Status Report

In May, you may have begun to receive from Quadax, a new weekly NEIC claim status report. This report contains information on the status of commercial claims submitted to NEIC. The report is provided to reduce the time needed to track claims. Often, the claim status report will replace a call to a claim office. When this is not the case, then the report provides a payor telephone number and claim reference number, that can make calls more effective

Messages on the status report are separated into five major groups:

1. Claim sent to claim payor
2. Payor acknowledges receipt of claim & provides reference #
3. Claim is pending at payor site
4. Claim adjudication has been complete
5. Special handling/unprocessed claim

A total of 26 payers participate in the claims status program, and they are as follows:

Level 1 - Limited to acknowledgment of claim receipt. Level 2 - Tracking of claims to completion

CLIENT SPOTLIGHT

Jjust a few short months ago, Quadax added Innova Medical Services, a large multi-specialty physician practice with locations throughout the Cleveland area., to our client list.

Someone once said "word of mouth is the best form of advertising" as is the case with Innova. Quadax was referred to them by Deaconess Health Systems as well as from one of the physicians who recently joined the multi-specialty practice who himself was a very satisfied current Quadax user. This physician reassured the group that Quadax has the staff and the experience to handle a large multi-specialty group such as Innova. We couldn't ask for a better advertisement than that!

With change comes anxiety... so we asked Mary Smith, Innova's Manager of Practice Services, how her staff received the conversion to the Quadax system. Ms. Smith said "they were relieved due to their dissatisfaction of their former billing system," and they were delighted that Quadax eased their load by establishing a financial office in their building to handle patient inquiries, walk-ins, practice questions, etc.

And what about the patients? They were said to be a little confused at first, but with a little extra patience and effort, put forth by all, the confusion was gradually replaced with understanding. The patients also are pleased with the Quadax office in the Innova building. They like the fact that they can meet face-to-face with someone who can help them work through a billing problem or physically accept a payment. The transition period is always a little hectic, therefore, the Quadax and Innova staff are hard at work!

We asked Ms. Smith what one thing she would tell another practice like Innova who was looking at Quadax to do their billing, Ms. Smith told us that she would tell them about our support. Good Service support is essential, and Quadax Service gives them the needed support they require. We attribute our continued success to the individualized customer service and technical support we provide our clients. Ms. Smith's statement reinforces that our hard work and dedication to service really does pay off- way to go Service!

Timely Tip

• Don't forget to use (216) 777-6305 when calling our Physician ADVANTAGE Customer Services Support Department!
• Effective immediately, you should no longer use "834" in the group number field for CMIC. It doesn't have to be removed from any patient accounts that already have "834" as the group number. The plan code field should still be complete with the appropriate "33X" plan code.

TO "Q" YOU IN

As was reported in the January and February 1995 issues of the Nationwide Medicare Newsletter, the volume of duplicate claims being submitted to Nationwide Medicare has skyrocketed! They have reported that the time and money it takes to process duplicate submissions is staggering. Please remember that it costs you to generate these claims you are not receiving payment for.

Nationwide has increased their efforts to reduce the volume of duplicate submissions by visiting the offices of those providers who have repeatedly submitted duplicates to assist them in resolving the issue. After all, as tax payers, we cannot allow this waste to continue.

If you have any questions regarding duplicate submissions, call the Medicare Provider Relations Division at (614) 464-9224 or their Electronic Media Claims Technical Support Area at (614) 249-1180.