Electronic Billing Receive Log Instructions

Use the Electronic Billing Receive Log routine to retrieve the electronic billing transmission logs from the insurance carrier.  The Receive Logs provide an audit trail that you sent the electronic billing file to the carrier.  The Receive Log routine will launch BLAST or other communications software and automatically log into insurance carrier's website (Anthem, for example) and check for the report dates that match the transmissions that you have sent.  After you select the option to download the Receive Log to your communications PC, and you log off, INSight will automatically upload the carrier Receive Log to the appropriate place on your system.  Once the Receive Log routine is completed and the Logs are uploaded you will need to return to the Review Log routine to view the uploaded receive reports.

Notes:

• The insurance carriers Anthem and WebMD have an automated Receive Log process.  After you click Proceed the steps in the receive process are done automatically for you.  For other carriers like Medicare, you must manually go through the Receive Log steps and manually select the reports to upload.  

• To distinguish between Review Logs and Receive Logs, Review Logs list Live and the Receive Logs list Log.

• Each insurance carrier's receive logs have a slightly different format, but in general each carrier provides the following information:

• Acknowledgement Report or 997 Report, also known as the Level 1 Report - Reports whether the insurance carrier's electronic billing file as a whole is accepted or rejected.  The Acknowledgement Report interprets the 997 Report in a simple, easy to read format and tells whether the file has been accepted or rejected as a whole.

• Receive Log or Error Summary Report, also known as the Scrubber Report (Medicare), Level 2 Report (Anthem) or Receive Log - Reports each claim in the electronic billing file and whether the claim is accepted or deleted (which means the claim failed) and the reason why it failed.

• Little p Report - Reports information pertaining to your Medicare Send session and reports the number of claims they received.  This report only pertains to Medicare.

• Notes:  

• For Medicare only, if your transmission is successful Medicare provides three reports.  

• For Anthem, if your transmission is not successful you will only receive the 997 Report.

• To reconcile the Receive Logs:

• Compare the Control Number on the Acknowledgment Report to Transaction Set Number on the electronic billing Print Journal.  They should match.

• Compare the Error Summary Report Totals Claims, Total Accepted and Total Deleted.  
  Important:  All deleted claims will need to be repaired.  For more information, see Electronic Billing Common Error Messages.

• Compare Submitted Total Charges to Total Charges amount on the electronic billing Print Journal.  They should match.

Directions:

To see directions for...

• Opening the Electronic Billing Receive Log Instructions, click More.

   

  1.  Click Billing Functions from the Menu Bar.

  2.  Click Communications.

  3.  Click Professional Claims.

  4.  Click Medicare.
  Note:  Medicare is used as the carrier in the menu example.  Please select the appropriate insurance carrier name for your processing.

  5.  Click Receive Log.

   

  Advanced Methods:
  
  Click the following sequence:
  From the Communications Floating Menu Panel, click the carrier name; and click Receive Log.

   

  Receive Log Window Example:

  

   

• Choosing the Automatic Receive Selections at the Prompt Window, click More.

   

  Electronic Billing Receive Log Instructions Prompts Tip:  To see more information about a field, click the hyperlink for the field name.
  Carrier Name	The Insurance Company Name displays for your reference.   Note:  It is important to confirm that you have selected the appropriate carrier for the Receive Log.
  Send Window Information	The following carrier information displays for your reference: Description - Carrier Code Description Carrier Type - Carrier Type which is used in the Send script Uppercase File - As specified by the Carrier Code Background Check - As specified by the Carrier Code Setup Sequence - the sequence number for the electronic billing session Transfer Sequence - The sequence number for the Transfer Send Sequence - As specified by the Carrier Code Last Date Transferred - Maintained on the Carrier Code Last Date Sent - Maintained on the Carrier Code Generated File Path - Carrier Code Transfer File Path Send File Path - Carrier Code Destination Path/File Launch Command - the script for sending the file to the carrier
  	To run the routine, click Proceed or press [ENTER]. Keyboard shortcut:  [ALT + p]
  	To escape from the routine: Click Cancel. Keyboard shortcut:  [ALT + c] Or, click Close .
  Receive Log Processing	Displays information pertaining to the various phases of the Receive Log routine to guide you.  When complete the window displays Done.
  	To close the routine when Done displays and the routine is finished, click Done or press [ENTER]. Keyboard shortcut:  [ALT + d]

   

• Choosing the Manual Receive Selections at the Prompt Window, click More.

   

  After choosing the menu selections for Receive Log, the following window displays:

   

  

   

  1. Click Proceed or press [ENTER].

  2. At the‘Bypass File Download To P.C.?: prompt, press [ENTER].  This will launch the BLAST software.  A blue screen should display.

  3. Press the down arrow key until the Medicare selection is highlighted.
   

  

   

  4. Press [ENTER] to connect to the Medicare system.  The modem will dial out.

  5. The following window displays.  Press [ENTER] to enter Terminal Mode.
   

  

   

  6. Press [ENTER] until the Submitter ID prompt displays.  Enter your Medicare Submitter ID and press [ENTER].  A Password prompt will display.  Enter your Medicare password and press [ENTER].
  
  NOTE: The password will not appear as it is entered.
   

  

   

  7. After a few seconds the CABBS MAIN MENU will display.  Select Electronic Mail Menu and press [ENTER].

  8. The CABBS ELECTRONIC MAIL MENU will display.  Select Display/Send/Receive Mail and press [ENTER] and the current contents of your Medicare Mailbox will appear.
   

  

   

  9. Look for the three file logs that should always appear after a Medicare Send:

  a. ANSI 997 report

  b. TEST ERROR SUMMARY -
  (Note:  After passing your test, ‘TEST’ will drop off the report name.)

  c. p####.#### EDIT - Also known as the Little p report.  
  Note:  After passing your test, the t will change to p.

  Enter 6 to select Download mail to PC and press [ENTER].

  10. A File List displays.  At the Select an item number prompt, enter the number of the mail file to retrieve.
   

  

   

  11. At the Transmission Protocol Menu, enter 3 to select Z-Modem and press [ENTER].
   

  

   

  12. The prompt Please press enter when you want us to start the send process displays.  To start the retrieval process, press [ENTER].

   

  

   

  13. Now the Medicare system is ready to send the file.  Press [Ctrl] and press [k] twice ([CTRL + [K] [K]).  
  This will open the BLAST menu at the top of your screen.

  14.  Press [f] Key (File transfer) to enter the file transfer menu.

  15. Press [g] (Get) to retrieve the currently selected file.  A File transfer window displays and will display a byte count down for your reference.

  16. When complete, the BLAST Menu displays at the top of the screen and the word Terminal is highlighted.  Press [ENTER] to return to the Medicare system.

   

  

   

  17. Return to step 9 and repeat the steps for all files that you need to download.  When finished, press [ENTER].

  18. When all files are downloaded, at the Mail Box Menu enter 7 to select Quit and press [ENTER].

  19. At the CABBS ELECTRONIC MAIL MENU select Exit and press [ENTER].

  20. At the CABBS MAIN MENU select Exit and press [ENTER].

  21. You have now logged off the Medicare system.  To disconnect the modem hold down the [Ctrl] key and press [k] twice ([Ctrl + [k] [k]]).

  22. The BLAST Menu displays at the top of the screen.  Press [d] and the modem will disconnect from the system.

  23. To escape from the BLAST system press [Esc] until the question Do you really want to leave BLAST? displays.   Use the right arrow to highlight Yes and press [ENTER].  

  29. The BLAST blue screen disappears and the INSight system will re-display.  To upload the file to the main system, press [ENTER].
  The review logs are now stored in your system and can be viewed by selecting Medicare Review Log.
  Note:  You should always choose the option to print and you should always choose to print the Acknowledgement Report as well, as this deciphers the ANSI 997 report for you.

   

• Report Sample(s), click More.

   

  To see an example of the report, click Acknowledgement Report Sample.

  To see an example of the report, click Receive Log or Error Summary Report Sample.

  To see an example of the report, click Little p Report Sample.