Starting the Application
Once the HIPAA Claim Payment Master is installed, you can launch it from the "Start" menu:
Start 
Programs (All Programs) HIPAASuite HIPAA Claim Payment Master.
The HIPAA Claim Payment Master is launched from the "Start" menu
The following screen will appear:
The HIPAA Claim Payment Master main window
Tip: If the left pane is not displayed, then select View Info Bar to show it.
Once the main program window is opened, the normal operation now would be to open an EDI file. See:
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Processing a Payment Advice File
Follow the instructions below to open a single EDI file and display its details on screen in easy-to-read table format.
| 1. | Go to File Open in the main menu. The "Open" menu Alternatively, click on the "Open Document" icon shortcut located on the program toolbar.  The "Open Document" button |
| 2. | Browse through the folders and select a file with .edi extension. Click "Open." |
Note: Only claim files in "ANSI 835" format can be opened via the Claim Payment Master. The program will display an error message if you select a file in a different format.
Reference: ANSI 835 is the American National Standards Institutes Health Care Claims Payment and Remittances Advice Format.
The "Choose EDI File" window
| 3. | Make sure the program tool bar is displayed in the left area. To display the left program bar with options, select View Info Bar. |
| 4. | Select one of the following modes in the "Output Mode" box. The Output mode defines the destination where the result file will be sent to. |
| • | Printer — Select this option to print the opened EDI file. |
| • | Screen — This is a default mode. select this option to display the EDI file on screen in a preview window. |
| • | Image File — Select this mode to create TIFF or PDF file. You should have the settings configured to print the file to image. Read more in Creating Image Files from EDI. The "Output Mode" options |
| 5. | Click on the "Run" button.  The "Run" buttons |
| 6. | When you click on the "Run" button, the file will be parsed and the information displayed. The HIPAA Claim Payment Master recognizes the type of the EDI transaction and displays Payment Advice and Claim Status information separately. The following pertains to the X12 835 Electronic Payment Advice. As in our example the output mode is "Screen," the claim is displayed in a separate window.  The display of an 835 Payment Advice |
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Opening a Folder Containing EDI Files
The "Open Directory" function works only when the output mode is not "Screen" but "Data Export" or "Image File".
Follow the instructions below to open a batch of EDI files located in one folder.
| 1. | Make sure the "Printer" or "Image File" mode is selected in the "Output Mode" box. The Output mode defines the destination where the result file will be sent to. |
Note: You cannot display a batch of EDI files on screen in a preview window, it is possible only for one file. See Processing a Payment Advice File.
The "Output Mode" options
Note: If you select the "Image File" format for the first time, you need to define the image options. See Doing Image Setup.
| 2. | Go to File Open Directory in the main menu. The "Open Directory" menu |
| 3. | Browse for the folder containing EDI files. Click on that folder and then click "OK." |
Note: Only claim files in "ANSI 835" format can be opened via the Claim Payment Master. The program will display an error message if you select a file in a different format.
Reference: ANSI 835 is the American National Standards Institutes Health Care Claims Payment and Remittances Advice Format.
The "Browse for Folder" popup
| 4. | Click on the "Run" button to send all files from the folder to the destination. |
Note: The pre-defined settings will be applied. To print the files to image, configure the settings. See also: Configuring Program Options, Doing Image Setup.
The "Run" buttons
5. The displayed "Processing Results" popup will report about operation results.
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Explaining HIPAA Claims
The HIPAA Claim Payment Master enables you to understand electronic remittance advices by translating HIPAA code sets into meaningful words. The HIPAA Claim Payment Master translates the code sets and orders the information so that you can see exactly what payments were made and which deductions taken.
The top part of the form contains:
| • | The sender and receiver of the transaction, that is the payer who paid the claim. |
The sender and receiver information of the 835 transaction located at the top
Further, you can find the following data:
| • | Patient information |
| • | Provider information |
| • | The claim level information |
| • | The claim line adjudication |
| • | Service line information |
Summary information is displayed upfront, and each claim listed with the adjudication information and service line information structured with all the details found in the EDI file.
835 transaction information structure
Further you can see more screen-shots of electronic remittance advices.
The claim level information with 1 REF segment, 3 DTP segments, 1 AMT segment and 1 QTY segment
Medicare Inpatient information from the MIA segment
On the following screen-shot, the Procedure Code is in the first top cell on the left. The "HC" stands for "HCPCS" codes which includes all HCPCS, ICD-9 and CPT codes. Other possible codes are "AD" for dental claims or "IV" for Home infusion codes and "N4" for NCPDP drug codes.
Adjustment Codes are translated into their descriptions, making it easy to understand the reasons behind any adjustments.
The line level information for a claim with 3 lines
Summary information contained in TS3 and TS2 segments can extend over multiple claims. The HIPAA Claim Payment Master will begin a summary range with a bracket and then show the summary information before listing the claims.
Beginning of the summary information block
Summary information is started with a bracket. At the end of a summary range is another bracket.
End of Summary information block
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Requesting a Trial Extension
Once your trial period has expired the application will stop working. If you need to continue your trial of the product, then you will need to send your request to the support team. Follow the instructions below.
1. Launch the application.
2. Click on the "Ask for trial Extension" link on the displayed window.
The "Ask for trial extension" link
3. Clicking on the "Ask for trial Extension" link will create an email to HIPAAsuite with the registration number so they can then create the extension key. For example, this will open Outlook with the following data inserted:
| • | To: |
| • | Subject: [HIPAA Claim Payment Master][123456789]: Request for trial extension key |
| • | Message: Volume ID: 123456789 |
The trial extension request email
4. The response from the support team should includes an activation key.
5. Once you have the activation key, click "Register" on the program welcome window.
The "Register" button
6. Paste the activation key into the field on the Registration Form and then click "Register."
The "Registration Form" window with entered license key and highlighted "Register" button
7. The success message will appear in the "Result" border.
The license activation result
Click "Close."
8. Once the license key has been entered, click "Try" on the welcome window to continue using the program for another 15 days.
The "Try" button
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