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Ohio MACSIS HIPAA Information

Last Updated 05/19/2009


Latest News on NPI Testing


Steps to a successful HIPAA transition

  • Purchase or upgrade to EZClaim Advanced with the direct billing module.
    Use the Ohio EZClaim Order Form
  • Download the following documents
    - ANSI Data Entry for MACSIS - Advanced 7 - Ohio specific information relating to the ANSI 837 and EZClaim
    - MACSIS 837 Professional Claim Information Guide - Guide from MACSIS showing ANSI field specific information. A must have reference.
    If sending COB information, refer to our COB Instructions for more information. 
  • Send test claims to your board for approval.
    All testing is coordinated through your board. Please contact your board for more information. We suggest using a product call FirstPass to test files before sending them to the board. The product is available at http://www.wpc-edi.com/firstpass/

Common questions and answers:


Q. Can EZClaim handle the NPI requirements?
A. Yes. EZClaim Advanced can export the NPI number required by HIPAA.

Q. Will EZClaim automatically roll-up services?
A. No. Having software automatically "roll up" services allows duplicate service entries to be rolled into one. The user would not know they just unintentionally double billed. The MACSIS system would also not catch the duplicate billing since the software rolled two services into one before sending. At this point, EZClaim feels the user should manually roll up services during data entry to avoid duplicate billing. See the MACSIS documentation page regarding rolling up services.

Q. Where can I find more information?
A. MACSIS maintains a very good web site with information on all aspects of HIPAA. Please visit http://www.mh.state.oh.us/ois/macsis/macsis.index.html for the latest information.

Q. Is EZClaim fully Ohio MACSIS/HIPAA compliant and that's all we need?
A. In terms of software, yes. EZClaim is all you will need to generate an ANSI 837 file and submit your billing to the board. The http://www.mh.state.oh.us/ois/macsis/macsis.index.html web page contains the documents you will need to bill MACSIS successfully.

Q. What is the testing procedure?
A. All testing is done through your board. Please contact them for more information.

Downloads

  • Patient Visits by Therapist - Report used in Basic 5 converted for use in Advanced 6. Used when the therapist's initials are entered into the Reference 1 field on the Patient Patient. You can also limit the report to a single therapist or single procedure code.

Links

Ohio DMH Home Page
Full ANSI 837 Specifications at http://www.wpc-edi.com/

BH Module (Obsolete)

  • BHClaim 1.6.76 Setup Size: 48 MB (Est. 2 Hours 56K) - Will not show an error for UCI numbers starting with a 3. File Name: BHClaimSetup1.6.76.exe
  • BHClaim 1.6.78 Update Size: 208 KB (Est. 30 seconds) - Fixes tabbing issue where the active row was not indicated. Also prevents having to tab twice when selecting data from a drop down menu. IMPORTANT! You must have BHClaim 1.6.76 (or higher) installed before updating to this release (see link above). File Name: BHClaim.1.6.78.exe