FAQs

Claim Editor To get to the Claim Editor screen, go to File/Manager, double click on a batch to open into the Batch Editor screen and then double click on a claim to open into the Claim Editor screen. Here, you can go through each claim and correct any errors that each claim has. The errors are represented by warnings at the bottom of the screens. Warnings in Claim Editor: Warnings – To correct your warnings, double click on a warning at the bottom of the claim editor screen. Once you double click on a warning SolAce will move your cursor to the appropriate tab that needs correction and it will highlight the specific field in the claim that needs to be corrected. Often, the fields will either have a drop down list or a magnifying glass next to it that will take you to a list of options to choose from to correct the error/warning. Navigation Arrows: To review each claim record within your batch, use the navigation arrows at the top of the screen. Important things to know about the Claim Editor tabs: Tabs – Each tab running across the top of the page after the CMS-1500 tab relates directly to a box in the CMS-1500 tab. Therefore, any information entered in the CMS-1500 fields will also be automatically populated into its related detail tab in the Claim Editor screen. All Fields – This tab brings you to a screen that contains a listing of data from all of the tabs in the Claim Editor screen, and can be a useful place to find an unusual piece of data that may be causing a problem. Important things to know about the Claim Editor buttons: Map – Clicking the map button at the bottom of the Claim Editor will open the map that is currently being used for your batch. However, the data that it will bring up in its background will reflect the last print file you generated in your system. It does not necessarily use the data of the claim you are currently viewing in Claim Editor. Verify – After correcting a warning, you should click on “Verify” to confirm that the error has been corrected. The error message should immediately disappear if the error correction was successful. Ignore – This button should only be used if you know for sure that the data being labeled as incorrect is in fact correct. To un-ignore previously ignored warnings, highlight the warning and press ignore again. Click Yes when prompted to confirm. Possible Problems and Causes: Problem Payments are going to a patient. Causes

1. “Medicare Participating” is not checked in the Provider’s File.
2. There’s an amount in Box 29 of the CMS-1500 form.

Solution To prevent this problem from happening, make sure that the “Medicare Participating” box is checked in the Provider’s file in the Setup/Provider/Provider File if the provider is a Medicare Participating provider. In addition, make sure that Box 29 in the CMS-1500 form reflects $0.00. If there is an amount showing, please double check your map and make sure that there isn’t an active field box sitting on top of Box 29. Problem Missing information for Commercial claims that you know is in your print file. Cause Commercial claims require more information than Medicare claims. If you used a Generic Medicare or Commercial map, some fields that are required for your commercial claims might not be activated or mapped properly in the map that you used. Solution Open your map and make sure that the following fields are enabled for the following claim types below:

• Medicare Claim Fields: 1-3,5, 8,9a, 9d, 10a-c, 12-21,24a,b, d, e, f, g, j, 26-29, 32-33.
• Commercial Claim Fields: In addition to the Medicare boxes, the following also need to be activated: 4,6,7,9b, 9c,and 11a-c.

Problem The wrong Diagnosis code is appearing in Box 24E or there is no entry appearing in Box 24E. Causes

1. The field for Box 24E might not be activated in your map.
2. Since SolAce did not find an entry in Box 24E it defaulted to show the first diagnosis code entered in Box 21.
3. Your print file did not have any Diagnosis code entries.

Solution

1. To check if the field for Box 24E is active and mapped properly, go to Setup/Maps and double click on the map you would like to check to open it into the Edit Map screen. In the Edit Map screen, change the setting in the Filter section at the bottom right hand corner from “Enabled Fields” to “All Fields”. Find the field for Box 24E on the fields list on the right panel and click on it once to select it. Once you’ve selected the field, SolAce will show you on the left (main) panel where the box is currently placed in your map. A check mark next to the field on the list will indicate that the field is active. At this time, please also look to see where the box for this field is placed in your map and make sure it is covering the correct information.
2. If your print file did not include an entry for Box 24E, SolAce will choose the first diagnosis code that is entered in Box 21. To correct this problem, you can manually enter the correct code. You should also correct this problem in your Practice Management system and make sure that it will include the proper Box 24E entries the next time you export your claims.
3. If your print file did not include any diagnosis code entries for Box 21 or Box 24E SolAce will not populate anything in those fields. Please correct this problem in your Practice Management system.