The Medical Manager™ by Sage Integration Notes

Well, we can't call this one a full article yet because integrating with Medical Manager is a tough one.

What we do know is that the Medical Manager produces claim files that can be transmitted with SolAce EMC instead of via the default clearinghouse. However, you should review your contract with Medical Manager to ensure this is legitimate use of your system.

If you have any experiences to share, revisions, or additions to this document that may help other users in the future, please edit this page and add your own notes. Below are the notes we have so far.

Acknowledgments
Big Thank You's to the freelance technicians who know The Medical Manager and have contributed to this document.

Printing Claims to a File
The Medical Manager supports generating HCFA-1500 print images to a file, just like it can do to a printer. By default The Medical Manager only comes with one form, and you will want to refer to the section on splitting claims below if you need more flexibility.

The trick is to go into the setup program that was used to initallly setup the system, and define a printer device as A:?. This instructs The Medical Manager to print to a disk file and ask you for the filename at the time of printing. You can also use a filename instead of a question mark if you want the claims to print to the same file every time.

The A: may look like a floppy disk drive letter to Windows/DOS users, but it is a device designation. Drives are aliases to these devices that you can setup in the setup program.

This technique and an example is covered in The Medical Manager documentation, in an Appendix section titled Application to Printer Map.

Once you have the form setup you use the Medical Manager menu named Billing & EDI, then choose Insurance Billing for Paper Claims to do a run of claims to your print file.

Notes on Filenames
Here is what filenames on our system look like:

30   09/26/03    A:NEICMCAR.030         33   10/01/03    A:NEICMCAR.033 
31   09/29/03    A:NEICMCAR.031         34   10/02/03    A:NEICMCAR.034 
32   09/30/03    A:NEICMCAR.032         35   10/03/03    A:NEICMCAR.035

Notice the filenames after the A:? those are the actual emc batches that are sent out (ie, NEICMCAR.032). Chances are, the A: is the c:\meddata directory (most installations default to meddata as the first drive). The A: is an environment variable that MM reads from a batch file (type "set" to see it from the command prompt). MM increments the file extension to know which batch to roll back should you need to (In this example, batch 32 done on 9/30).

If you save the file and it says EMC BATCH FILE STATUS REPORT at the top then you've saved the batch summary. Look on that summary report for the actual filenames that contain the EMC claim data, and save those files off instead.

Transferring a print file from a Unix server
Users of The Medical Manager that are running a console-only Unix server will need to run SolAce EMC on a workstation that runs a graphical desktop (Windows PC, Mac OS X, or Unix/Linux with XWindows installed).

Copying via FTP
There are two ways of retrieving the claims file from the Unix server. One way is to use an FTP client utility to copy the file over. We recommend the free and very easy to use FTP client named FileZilla, available for download at http://filezilla.sf.net.

As of SolAce version 2.1.14: The other way is to use an FTP URL in the SolAce System Options screen. This requires you to put the username and password for your Unix server login, as well as the full path to the print file, in SolAce. Go to Setup / System Options on the menus, then enter the FTP URL in the print file or NSF file field, depending on what type of file you will be importing. An example FTP URL is ftp://username:password@myserver/tmp/claims.txt. This would cause SolAce to try downloading from the FTP server named myserver, with a login of username and password of password, the file named /tmp/claims.txt residing on that server.

Copying via Floppy
We had to copy the file off our Medical Manager system with a floppy disk. This is done by using the Unix console and entering a \copy command. This prompts for the filename and then copies it to the floppy disk.

Splitting Claims
Some SolAce EMC users have needed to separate the claims into separate batches to avoid sending all the claims to SolAce for processing. This has been the case when a payer is not on any electronic payer lists, and when the user would rather print them to paper than use the clearinghouse's print-and-mail service for .XX cents per claim. This might also be useful if you want to format the claim forms differently for Medicare versus other payers, as would be the case for Ambulance companies, for example.

To accomplish this you have to make a copy of the form you normally use. You can find the format files for the claims forms in The Medical Manager's installation folder. The file names start with "ins", are followed by two 2-digit numbers representing the form and format, then a letter like a (paper) or c (EMC), and a ".fmt" file suffix. An example of form #1 and format #1 for paper claims is ins0101a.fmt.

You can find out what form/format is being used for your claims currently by visiting the Claim Center feature (type /m13 for menu 13) in The Medical Manager. Look at the specific claim center and see what form and format is being used. If the form is 2 and format is 3 then the format file it is using would be named ins0203a.fmt.

To duplicate the form just make a copy of the format file and name it in the right convention. For example, if we want to make a copy of form #2 format #3 so we have a form #3, we would copy the file named ins0203a.fmt to a file named ins0303a.fmt. Then, go back to the Claim Center feature in The Medical Manager and attach to the form/format by specifying the new form and format numbers in the claim center.

If you want to actually alter the form to make it different then you will have to consult with a The Medical Manager technician or edit the insXXXXa.fmt file to change your formatting. Altering the form is beyond the scope of this tip sheet.

Print Image vs. NSF Files
SolAce EMC can import claims from a print file or National Standard Format (NSF) electronic claims file. Our Medical Manager users so far report good success with the print file option, although it is reportedly a pain to setup for non-technical users. We have also heard that if you are already using The Medical Manager's add-on for electronic claims then your system has the capability to produce NSF files, which SolAce can then process for you. We have no specific instructions on how to generate NSF files from The Medical Manager at this time, other than you would just transfer the NSF file to SolAce rather than letting it transmit to the clearinghouse.

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