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MediSoft®
Electronic Claims Direct
Lightning-Fast Insurance Claims
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 Many health care billing programs can send insurance claims with a modem. MediSoft has many options for electronic claims -- from clearing house claims for easy, universal access, to direct electronic claims modules for selected insurance carriers that eliminate per-claim fees. All MediSoft software includes clearing house electronic claims software at no extra charge.

Electronic Claims are Faster than Paper
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 Electronic claims significantly reduce the amount of time a practice waits to be paid for their services. On average, electronic claims are paid in half the time of paper claims. Electronic claims improve payment speed in two ways: First, the mail system is avoided. An electronic claim can arrive at a carrier's office within 24 hours and be ready to be paid by their computer. Contrast this with the time it takes for the post office to deliver the mail and data entry staff at the carrier's office to enter the claim information! Second, insurance carriers give priority processing to electronic claims. Medicare processors cut two weeks off their payment time to give providers the incentive they need to send claims electronically!
Which Claims Can Be Sent Electronically?
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 MediSoft Direct Electronic Claims software is offered for selected insurance carriers. Medicare, Medicaid and Blue Cross/Blue Shield accept claims directly from providers and billing services in most areas. Few other carriers offer this option, making MediSoft clearing house claims the perfect partner with direct claims modules in most practices.
Electronic Claims are as Easy as Paper
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 Billing data is entered into MediSoft, then is used to print paper claims or submit claims electronically. No additional data entry is required -- Just select the Electronic Claims menu option!
Free Electronic Claims Software Isn't Free
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 Carrier-supplied software works differently than MediSoft, requiring extra time to learn and use. Claim information sometimes must be entered a second time to use carrier-supplied software. MediSoft Direct Claims modules work inside MediSoft, using the same familiar menu structure and commands. Carrier Tested and Approved
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 Works Inside MediSoft
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 No Data Reentry
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 Usually No Per-Claim Fee
Direct Electronic Claims Modules
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 When a practice sees a concentration of patients who are insured by a particular insurance carrier, direct insurance claims can save the per-claim fee common with claims clearing houses.

Currently Available Direct Claims Modules
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 Following are currently available MediSoft Direct Claims modules. Availability of ERA Auto Pay, a MediSoft product for automatically applying payments based on Medicare's electronic remittance advice, is noted in the ERA column. Contact your independent MediSoft dealer or MediSoft for details.
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*Indicates the EMC All Payer Module
State
Code
Carrier
Claims Accepted
ERA
ALL
 MedUnite MediSoft Electronic Claims Powered by MedUnite All
Y 
*AR
 ARMB Blue Cross and Blue Shield of Arkansas Medicare Part B, Blue Cross and Blue Shield
Y 
AZ
 AEMA Aetna (submits to BC/BS of ND) Medicare Part B
Y 
*AZ
 APN1 Arizona All Payor Network Medicare Part B, Blue Cross and Blue Shield, Commercial
N 
CA
 CABS National Heritage Insurance Company Medicare Part B for Northern California
Y 
CA
 CAMC MediCal MediCal
N 
CO
 NDMB Blue Cross and Blue Shield of North Dakota Medicare Part B
Y 
CT
 TRMB FCSO Medicare Part B
Y 
DC
 MDTB Maryland Trailblazers Medicare Part B
Y 
*DC
 MHIN Maryland Health Information Network Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
N 
DE
 DETB Delaware Trailblazers (Windows only) Medicare Part B
Y 
DE
 MDTB Maryland Trailblazers Medicare Part B
Y 
*FL
 FLMB Blue Cross and Blue Shield of Florida Medicare Part B, Blue Cross and Blue Shield, Health Options, Champus, Commercial
Y 
*FL
 FLMC Florida Medicaid FL Medicaid, W.V. Medicaid, W.V. Workers Comp, CO Medicaid
N 
GA
 AEMA Aetna (submits to BC/BS of AR) Medicare Part B
Y 
HI
 AEMA Aetna (submits to BC/BS of ND) Medicare Part B
Y 
*HI
 HMSA Hawaii Medical Service Assoc. HMSA, Quest, Medicaid
N 
*IA
 INET Iowa INET Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
N 
*IL
 ILBB Blue Cross and Blue Shield of Illinois Medicare Part B, Blue Cross and Blue Shield, Medicaid, Champus, Commercial
Y 
IL
 WPSI Wisconsin Paperless System Medicare Part B
Y 
*IN
 AIM1 Indiana Administar Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
Y 
*KY
 KYMB Administar Federal of Kentucky Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
Y 
LA
 ARMB Blue Cross and Blue Shield of Arkansas Medicare Part B
Y 
MA
 NHIC National Heritage Insurance Company Medicare Part B
Y 
*MD
 MHIN Maryland Health Information Network Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
N 
MD
 MDTB Maryland Trailblazers Medicare Part B
Y 
ME
 NHIC National Heritage Insurance Company Medicare Part B
Y 
MI
 WPSI Wisconsin Paperless System Medicare Part B
Y 
MN
 TRMB Wisconsin Physicians Services Medicare Part B
Y 
MO
 ARMB Blue Cross and Blue Shield of Arkansas Medicare Part B for Eastern Missouri
Y 
MS
 TRMB Cahaba GBA Medicare Part B
Y 
*ND
 NDMB Blue Cross and Blue Shield of North Dakota Medicare Part B, Blue Cross and Blue Shield
Y 
NH
 NHIC National Heritage Insurance Company Medicare Part B
Y 
*NJ
 PABS Pennsylvania Electronic Medicare Service Medicare Part B, Blue Cross and Blue Shield, Commercial (NJ physicians need a PA Blue Shield submitter ID to submit commercial claims)
Y 
NM
 AEMA Aetna (submits to BC/BS of AR) Medicare Part B
Y 
NM
 ARMB Blue Cross and Blue Shield of Arkansas Medicare Part B
Y 
NV
 AEMA Aetna (submits to BC/BS of ND) Medicare Part B
Y 
NY
 GHIC Group Health Incorporated Commercial
N 
NY
 NYGH Group Health Incorporated Medicare Part B for Queens
Y 
NY
 NYUM New York Upstate Medicare Division Medicare Part B for Upstate Area
Y 
*NY
 NYEB Empire Blue Cross and Blue Shield Medicare Part B, Blue Cross and Blue Shield, Commercial
Y 
NY
 NYMA New York Medicaid New York Medicaid Primary and Secondary
N 
OH
 OHMB Nationwide Mutual Insurance Medicare Part B
Y 
*OH
 AIM1 Indiana Administar Blue Cross and Blue Shield, Commercial
Y 
OK
 AEMA Aetna (submits to BC/BS of AR) Medicare Part B
Y 
OR
 AEMA Aetna (submits to BC/BS of ND) Medicare Part B
Y 
*PA
 PABS Pennsylvania Electronic Medicare Service Medicare Part B, Blue Cross and Blue Shield, Commercial
Y 
SD
 NDMB Blue Cross and Blue Shield of North Dakota Medicare Part B
Y 
*TN
 TNBB Blue Cross and Blue Shield of Tennessee Medicare Part B, Medicaid, Blue Cross/Blue Shield, Commercial
N 
*TX
 TXBB Texas Health Information Network Medicare Part B, Blue Cross and Blue Shield, Medicaid, Commercial
Y 
VA
 TRMB TrailBlazers Medicare Part B
Y 
VT
 NHIC National Heritage Insurance Company Medicare Part B
Y 
WA
 AEMA Aetna (submits to BC/BS of ND) Medicare Part B
Y 
*WA
 NDEX Network Data Express Medicare Part B, Blue Cross and Blue Shield, Medicaid, Department of Labor and Industries, Commercial
N 
*WA
 WMSC Premera Blue Cross Medicare Part B, Blue Cross and Blue Shield, Medicaid, Department of Labor and Industries, Commercial
N 
*WA
 NWMB Northwest Washington Medicare Part B, Blue Cross and Blue Shield, Commercial
N 
WI
 WPSI Wisconsin Paperless System Medicare Part B
Y 
WV
 OHMB Nationwide Mutual Insurance Medicare Part B
Y 
*WY
 NDMB Blue Cross and Blue Shield of North Dakota Medicare Part B, Blue Cross and Blue Shield
Y 
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