Revision Date: May 17, 2006

Transcription

1 F TCP/IP USER GUIDE FOR MEDICAL & INSTITUTIONAL PROVIDERS Revision Date: May 17, 2006

2 TABLE OF CONTENTS INTRODUCTION...1 Preface...1 Overview...1 GENERAL INFORMATION...3 TCP/IP Provider Requirements...3 Zipped vs. Unzipped File Requirements...3 Sending files to Empire...3 Retrieving files from Empire...3 Files & Reports Available for Retrieval Inbound File Audit Log EMC Receipt Report Blue Cross Blue Shield & Quicklink (EMCD6102) EMC Receipt Report Medicare Part A & Medicare Part B (EMCD6100) X Acknowledgement Confirmation Report (EMCDC060) Commercial Provider Daily Statistics Report (R022) X TA1 Interchange Acknowledgement X Claim Status Response X version 4050 Unsolicited Request for Additional Information X version 4010A1 Remittance Medicare Part A Inbound Reject (HB997ZRJ-A) & Accept (HB997ZAC-A) Reports Medicare Part A Claims Returned to Provider (FISS 050 Report) Medicare Part B Return Report X IG Edit Report...5 Helpful FTP Commands and Notes...6 HOW TO DIAL-UP TO EMPIRE...7 HOW TO LOGON TO THE EMPIRE FTP SERVER...9 HOW TO SEND FTP FILES TO EMPIRE...10 HOW TO RETRIEVE YOUR FILES FROM EMPIRE VIA FTP...12 HOW TO LOGOFF FROM THE EMPIRE FTP SERVER...13 HOW TO NAME YOUR FTP FILES...14 Inbound Files...14 Institutional Claims...14 Medical Claims...14 Medicare Part A and Part B X version 4010A1 Claim Status Request...14 Outbound Files...15

3 Outbound Files that are Available as Cur and Dated Files...15 Outbound Files that are Available as Dated Files Only...17 HOW TO ACCESS EMPIRE OMNIPRO SM WITH TN3270 EMULATION...20 Suspended Logons...21 TECHNICAL ASSISTANCE...22

4 INTRODUCTION Preface Empire supports file transfer via Transmission Control Protocol/Internet Protocol (TCP/IP) File Transfer Protocol (FTP). This communication method enables data centers to move large amounts of data and share information quickly and efficiently. Empire supports TCP/IP communication via dial-up or a dedicated line. In addition, providers with TN3270 emulation may access the Empire OMNIPRO sm interactive system for claim entry, claim correction, and inquiry functions. FTP is a communication method good for the small to large volume submitter and is intended for use by customers who have technical assistance available for initial setup, testing, and production support. Note: Empire will only support FTP included with Native Windows 95, Native Windows 98, Native Windows ME, Native Windows 2000 Professional, WINDOWS NT and Windows XP. Other TCP/IP FTP programs may be used, but Empire will not provide technical assistance. Overview FTP was designed with both security and flexibility in mind and supports transfer of files from one computer to another. The type of computer can be a PC running Windows, a mid-range running Unix, or a mainframe running IBM MVS. FTP is designed to transfer files between these different types of systems. When receiving or sending files to Empire, certain steps are required for success. Depending on your operating system and FTP software used, these steps may require modification. This manual is designed for a Windows operating system running on a PC using the FTP software included with Windows. Your operating system and/or software may require modification to these steps. However, the concepts still remain the same. First, you must establish a physical connection to Empire's IBM mainframe. Dial-up users need to establish the connection by dialing the network access number and providing the necessary dial-up system logon and password. Accessing the dial-up network requires a separate logon and password for security purposes. This establishes the physical connection to Empire. Those submitters who use a direct connection, like frame relay, do not have to dial the access number as they already have a physical connection to Empire. Second, you need to logon to the Empire IBM mainframe and provide the Empire logon and password for security. This logon is required to gain access to Empire's mainframe FTP software. All submitters are required to provide this logon and password to gain access. Dialup users will be required to provide two different logons and passwords, one for access to establish the physical link and one to gain access to Empire's system. Third, to send a file to Empire, certain FTP commands are required to tell the IBM mainframe software the necessary file attributes for the type of file being sent. It is imperative to use the correct file attributes. If this step is skipped, the default file attributes will be used to create the REV (5/17/06) 1

5 file on the Empire mainframe computer and your file will not process as expected. For example, if you are sending a claims file and the attributes are missing, the file will still transmit. However, the file will not pass validation and will reject due to the missing attributes. Using the incorrect file attributes for your file will have the same results. For example, if you send an X12 file with an LRECL (a.k.a. record length) of 320 rather than 32004, FTP will transfer the file, but the Empire mainframe validation software will not be able to process the file and all claims in that file will be rejected. Fourth, for file transfer to Empire, the FTP "append" command is recommended for unzipped files. The "append" command will not write over any previous file with the same filename still waiting to be processed. If you transmit more than one file with the same Empire filename, the subsequent files will be appended (i.e., added to) the previous file(s) sent that day. Fifth, when transmitting or receiving files from Empire, the FTP commands require a local filename (i.e., your filename) and a remote filename (i.e., Empire's). The "append" command transfers your file from your PC to Empire. The "get" command transfers files from Empire to your PC. If either the local or remote filename is omitted, FTP will either default or not process. In either case, you may not get the anticipated results. For providers who want access to Empire OMNIPRO sm, TN3270 emulation must be established and the provider must obtain an OMNIPRO sm logon for access to the interactive system. REV (5/17/06) 2

6 GENERAL INFORMATION TCP/IP Provider Requirements Required for network connectivity: high-speed (e.g. frame relay) or dial-up connection. Dial-up connection should utilize 28.8 speed modem or higher. Required for sending and retrieving files: FTP software (i.e., Native Windows 95, Native Windows 98, Native Windows NE, Native Windows 2000 Professional, NT or XP). FTP in Windows is case sensitive. All entries must be in lower case. FTP will not recognize uppercase commands. Note: Other FTP programs may be used, but Empire will not provide technical assistance. Required for access to Empire OMNIPRO sm : TN3270 emulation software. Zipped vs. Unzipped File Requirements Empire does not support zipped file formats for inbound and outbound files. Sending files to Empire The following inbound files are supported for institutional: Medicare Part A Claims (HIPAA X12 837) Blue Cross Claims (HIPAA X12 837) QuickLink sm Institutional Commercial Claims (HIPAA X12 837) Medicare Part A X claim status requests (HIPAA X12 276) Medicare Part A X12 997, to acknowledge receipt of a HIPAA X remittance received from Empire Medicare Services. The following inbound files are supported for medical: Medicare Part B Claims (HIPAA X12 837) Blue Shield Claims (HIPAA X12 837) QuickLink sm Professional Medical Claims (HIPAA X12 837) Medicare Part B X claim status requests (HIPAA X12 276) Medicare Part B X12 997, to acknowledge receipt of a HIPAA X remittance received from Empire Medicare Services. Retrieving files from Empire Cur (current) files are retained only until overlaid by a newer file created out of a processing cycle, e.g. nightly roll-up into a single dated file. Dated files are retained for 45 calendar days except for the Confirmation Report (EMCDC060), which is retained for 14 calendar days. Files are available for retrieval unzipped only. REV (5/17/06) 3

7 Files & Reports Available for Retrieval 1. Inbound File Audit Log Displays date and military time an inbound file was accepted and forwarded for frontend edit processing, or date and time an inbound file was rejected and not forwarded for front-end edit processing. Also displays submitter number, submitter name and messages indicating inbound files were accepted or messages indicating inbound files were rejected. Updated hourly after submission of inbound files for Medicare Part A, Medicare Part B, Empire Blue Cross and Blue Shield and Quicklink sm. 2. EMC Receipt Report Blue Cross Blue Shield & Quicklink (EMCD6102) Displays ISA and GS errors, TA1 errors, 997 validation results, implementation guide (IG) errors, provider level, and business level errors for Empire Blue Cross and Blue Shield and QuickLink sm Commercial claims submitted in the X version 4010A1 and higher formats. Report is available for retrieval within 24 hours after receipt of your claim file at Empire. 3. EMC Receipt Report Medicare Part A & Medicare Part B (EMCD6100) Displays ISA and GS errors, TA1 errors, 997 validation results, and submitter validation errors for Medicare Part A and Part B. Provider batch errors are displayed for Medicare Part A only. Report is available for retrieval within 24 hours after receipt of your claim file at Empire. 4. X Acknowledgement Performs standard level editing of the Functional Groups (GS/GE) and the Transactions within the Functional Group (ST/SE) for X12 transactions received by Empire. Report is available for retrieval within 24 hours after receipt of your claim file at Empire for claim submissions. 5. Confirmation Report (EMCDC060) Provides notification of error conditions for X and X version 4010A1, when applicable. Report is available for retrieval within 24 hours after receipt of your file at Empire. 6. Commercial Provider Daily Statistics Report (R022) Displays the number of X version 4010A1 Empire QuickLink sm claims paid and the details of claims rejected by WebMD. Report will be returned from WebMD the next business day after the Empire QuickLink sm processing cycle. Available only as a dated file. 7. X TA1 Interchange Acknowledgement Returns ISA header and GS segment errors found in the X Claim Status Request transaction for Medicare Part A and Medicare Part B. Report is available the next business day after receipt of your file at Empire. 8. X Claim Status Response Provides the responses to inquiries submitted in the X Claim Status Request transaction for Medicare Part A and Medicare Part B. Report is available the next business day after receipt of your file at Empire. 9. X version 4050 Unsolicited Request for Additional Information Used to request additional required information, or clarification about information contained in a claim submitted to Medicare Part A or Medicare Part B under medical or utilization review. Available only as a dated file. REV (5/17/06) 4

8 10. X version 4010A1 Remittance Production or test files available upon request for Blue Cross, Blue Shield, Medicare Part A, and Medicare Part B. Available only as dated files. 11. Medicare Part A Inbound Reject (HB997ZRJ-A) & Accept (HB997ZAC-A) Reports For HIPAA X claim and X claim status request production and new biller test transmissions. The Inbound Reject Report displays errors for 837 claims and 276 claim status requests that fail Medicare s implementation guide (IG) edits. The Inbound Accept reports displays claims that passed editing and were accepted for processing into the FISS Shared Standard System. Reports are available the next business day after receipt of your files at Empire. Note: For X claim submission, this report is in addition to the EMC Receipt Control Report (file/batch level returns). 12. Medicare Part A Claims Returned to Provider (FISS 050 Report) Displays FISS Reason Codes received on new biller test claims submitted in the X format. Report is available the next business day after receipt of your file at Empire. 13. Medicare Part B Return Report Displays Medicare Part B errors received on new biller or production claims submitted in the X format. Report is available the next business day after receipt of your file at Empire. 14. X IG Edit Report Medicare Part B Only. Displays errors for production or new biller test data that is not in compliance with instructions found in the X12 276/277 Implementation Guide for version X093A1. Report is available the next business day after receipt of your file at Empire. REV (5/17/06) 5

9 Helpful FTP Commands and Notes dir Displays a list of files and the file attributes (e.g., lrecl, blksize) available on Empire s mainframe that begin with your Empire FTP logon ID. Empire retains output files for approximately two months. Consequently, the number of files available for retrieval can be numerous. You can "filter" the dir display list by adding filenames to the "dir" command to specify and limit the files that are displayed as noted in the examples below: To display: Display all files All current files Current confirmation reports All confirmation reports Current Medicare receipt reports All Medicare receipt reports Current New Biller files All New Biller files ls pwd quit Enter: dir dir *.*.*.cur* dir *.*.dc060.cur* dir *.*.dc060.* dir *.*.d6100.cur* dir *.*.d6100.* dir uemc.*.*.cur* dir uemc.* Displays files same as dir without the file attributes (lower case LS). Displays current directory. Exits FTP session. NOTE: NOTE: NOTE: Do not use the TCP/IP FTP command 'delete' to delete files. Any files deleted will not be restored. Do not use the TCP/IP FTP command ren to rename files. Empire regularly purges older files to maintain sufficient space for future files. Empire advises FTP users issue the APPEND command for inbound files. However, some FTP client programs do not support APPEND. PUT or SEND, valid FTP commands, can be used but will overwrite any inbound file of the same name not already processed by Empire. FTP users can verify a file has been processed by issuing a DIR command followed by the name of the file, e.g. DIR emc.x12.unzip. If the file is not listed, Empire has processed the inbound file. Empire also provides an audit log that details the date and time an inbound file was processed. Review the Outbound Files section of How to Name Your FTP Files for more information. An effort should be made to obtain and utilize an FTP client that supports APPEND. Empire cannot restore a file that has been overwritten. Use PUT or SEND at your own risk. REV (5/17/06) 6

10 HOW TO DIAL-UP TO EMPIRE Windows and Linux users should obtain a copy of AT&T s Global Network Client software from IVANS to establish a dial-up connection to Empire. IVANS provides enduser installation and configuration support for AT&T s Global Network Client. Windows Dial-up Networking and other Point-to-Point Protocol (PPP) dialer software programs can be used to establish a connection to Empire but are not supported by IVANS or Empire. Information listed here is presented as-is and may be helpful if unsupported software is used to establish a dial-up connection. Those using AT&T s Global Network Client should review the instructions provided with your software detailing how to connect and/or disconnect from the network and go to the section titled HOW TO LOGON TO THE EMPIRE FTP SERVER. For assistance obtaining, installing, and configuring AT&T Global Network Client software, contact the IVANS Helpdesk at (888) The following information may be helpful if a non-empire approved software program is used: o Dial-up access numbers can be obtained by visiting AT&T s website at o Connectivity to Empire s network is established using Point-to-Point Protocol (PPP). o End-user network client configuration information is provided via Dynamic Host Configuration Protocol (DHCP), no static IP addresses are used. o AT&T expects the network user ID in the following format during the logon process: secureip.account ID.user ID, e.g. secureip.myacctid.myuserid. o When changing a password or logging on for the first time, enter your current password followed by a period, then enter your new password, i.e. current password.new password o Password Guidelines IVANS/AT&T Passwords expire every 60 days. The password must be 6 to 8 characters in length. The password must contain at least one non-alphabetic character. The first and last characters of the password must be non-numeric. The password must not contain four consecutive characters from the old password. The password must not contain three identical adjacent characters. The password must not contain your user ID. o UNIX/Linux users may be able to use a combination of the PAP-secrets file, a Chat script, and a PPP Daemon to logon to Empire s network. PAP-secrets should contain a line similar to the following when changing a password or logging on for the first time: "secureip.account id.user id" * "current password.new password" PAP-secrets should contain a line similar to the following when logging on normally: "secureip.account id.user id" * "current password" There may be no additional prompting (i.e. no confirm new password prompt) returned when logging on using PPP. Enter a new password in pap-secrets once. Use the PPP daemon rather than the chat script to logon to the PPP server. The PPP daemon logon process should use information in pap-secrets. Using chat to logon may present a different interface and may interfere with REV (5/17/06) 7

11 the sending of logon information in the appropriate format. Chat should only be used to initialize the modem and/or call the dial-up server. Re-direct your system s standard output to a log file so error messages and successful log on messages can be reviewed and/or used for troubleshooting. Remember to disconnect your computer from the network when your session is finished. Submitters/Providers are responsible for all usage charges incurred while connected. Refer to the documentation included with your dial-up software for information about disconnecting from a network. You are now ready to logon to the Empire FTP server to send and retrieve your files. Refer to instructions in the section on "How to Logon to the Empire FTP Server". REV (5/17/06) 8

12 HOW TO LOGON TO THE EMPIRE FTP SERVER Note: FTP in Windows is case sensitive. All entries must be in lower case. FTP will not recognize uppercase commands. To LOGON to the Empire FTP server: 1. Go to the MS-DOS prompt on your PC: After the c:\> prompt: If dial-up, type: ftp OR If dedicated line, type: ftp nnn.nnn.nnn.nnn (Variable number; will be supplied for each dedicated line) Press: Enter The following message should appear: Connected to FTPD1 IBM FTP CS V1R4 at SYSG, 11:39:08 on Type your Empire assigned FTP logon ID after the following prompt: User ( none)): (Type your FTP logon ID) Press: Enter The following message should appear: 331 Send password please. 3. Type your Empire assigned FTP password after the following prompt: Password: (Type your FTP password) Note: For security reasons, your password will not be displayed as you type it in. Press: Enter The following message should appear: 230 (FTP logon ID) is logged on. Working directory is "(FTP logon ID).". ftp> Note: If you see this message, you have a successful connection REV (5/17/06) 9

13 HOW TO SEND FTP FILES TO EMPIRE Note: FTP in Windows is case sensitive. All entries must be in lower case. FTP will not recognize uppercase commands. To SEND a file to Empire (after successful connection): 1. Determine the type of file to be sent: X Claim File, X12 276, or an X acknowledging receipt of an X remittance received from Medicare. 2. Determine file attributes: must be unzipped. 3. After the ftp> prompt, enter the following "quote site" command for sending an X12 file (e.g. 837, 997, 276): quote site recfm=vb lrecl=32004 blksize=32008 Example, if you are sending an X12 837, X or X12 997: After the ftp> prompt: Type: quote site recfm=vb lrecl=32004 blksize=32008 Press: Enter The following message should appear: 200 SITE command was accepted ftp> 4. Next step, after the ftp> prompt, if your file is unzipped enter "ascii" as follows: Example: After the ftp> prompt: Type: ascii Press: Enter The following message should appear: 200 Representation type is Ascii NonPrint ftp> Note: Do not use the binary command for unzipped and X12 files. REV (5/17/06) 10

14 5. After the ftp> prompt, type append. Note: The Empire filename of your inbound file must be entered as shown in the "How to Name Your FTP Files" section of this user guide. Your FTP logon ID (FTnnnnnn) will be added systematically to the beginning of the filename. Example: If you are sending an X12 837, X or X production file: After the ftp> prompt: Type: append c:\localfilename emc.x12.unzip Press: Enter If you are sending a X or X test file: After the ftp> prompt: Type: append c:\localfilename uemc.x12.unzip Press: Enter A series of messages will appear indicating the status of your file transfer. The information you typed in will be displayed for your review and verification. Every time you send a file, the "quote site" and "ascii" commands must be repeated before each "append" command. If these commands are skipped or entered incorrectly, Empire will not be able to process your file. REV (5/17/06) 11

15 HOW TO RETRIEVE YOUR FILES FROM EMPIRE VIA FTP Note: FTP in Windows is case sensitive. All entries must be in lower case. FTP will not recognize uppercase commands. To RETRIEVE a file from Empire (after successful connection): Type dir to list all of your files available for retrieval and press Enter. After the ftp> prompt, type get then 1 space followed by the empire filename then 1 space followed by c:\ and your local filename. Note: The empire filename you want to retrieve must be entered as shown in the "How to Name Your FTP Files" section of this user guide. Your FTP logon ID (FTnnnnnn) will be added systematically to the beginning of the filename. Example: If you are retrieving your Medicare Part A X remittance, unzipped: After the ftp> prompt: Type: get emc.d0692.rmta.cur c:\localfilename Press: Enter The following message should appear: 250 Transfer completed successfully. REV (5/17/06) 12

16 HOW TO LOGOFF FROM THE EMPIRE FTP SERVER To LOGOFF from the Empire FTP server: After the ftp> prompt: Type: quit Press: Enter The following message should appear: 221 Quit command received. Goodbye. Remember to disconnect your computer from the network when your session is finished. Submitters/Providers are responsible for all usage charges incurred while connected. Refer to the documentation included with your dial-up software for information about disconnecting from a network. REV (5/17/06) 13

17 HOW TO NAME YOUR FTP FILES Inbound Files It is critical that your claim file is named correctly. Production files begin with emc and test files begin with uemc. If the filename is misspelled, it will not be processed. FTnnnnnn is your FTP logon ID. FTnnnnnn will be systematically added to the beginning of your inbound filename. Note: Empire does not support zipped file formats for inbound and outbound files. Institutional Claims Production 837: emc.x12.unzip (Blue Cross, Medicare Part A, Institutional QuickLink sm ) New Biller Test 837: uemc.x12.unzip (Blue Cross, Medicare Part A, Institutional QuickLink sm ) Medical Claims Production 837: emc.x12.unzip (Blue Shield, Medicare Part B, Professional QuickLink sm ) New Biller Test 837: uemc.x12.unzip (Blue Shield, Medicare Part B, Professional QuickLink sm ) Medicare Part A and Part B X version 4010A1 Claim Status Request emc.x276.unzip uemc.x276.unzip Production and New Biller Test X Acknowledges receipt of an X Remittance Received from Medicare emc.r997.unzip REV (5/17/06) 14

18 Outbound Files FTnnnnnn is your FTP logon ID. FTnnnnnn will be systematically added to the beginning of your outbound filename. Current (cur) and dated (xzyymmdd) files are created for outbound files. Cur files are only created for outbound files that may be produced multiple times per day (e.g., EMC Receipt Reports, 997 Acknowledgements). The hh following the cur in the filename is the hour that the cur file was created in military time. Dated files are created for all outbound files. At the end of the day, the cur files are rolled up into a dated file for that day. The cur files are then deleted and replaced with the dated file. Files that are produced once per day (e.g., remittances, Medicare return reports and 277 Claim Status) are available only as dated files. The filename ending with "xzyymmdd" is the date the file was created in yymmdd format. Dated files may be retrieved after midnight. "X" is a constant. "Z" indicates the century (actual value is 2 for 2000). Note: Empire updates the Inbound File Audit Log hourly but this file does not utilize the naming convention described above. Note: Empire does not support zipped file formats for inbound and outbound files. Note: PLEASE DO NOT USE THE TCP/IP FTP COMMAND 'DELETE'. ANY FILES DELETED CAN NOT BE RESTORED. Inbound File Audit Log for Medicare Part A, Medicare Part B, Empire Blue Cross, Empire Blue Shield and Quicklink sm Inbound files emc.d0066.auditlog uemc.d0066.auditlog Outbound Files that are Available as Cur and Dated Files Note: Cur files cur00 to cur23 are rolled up to the dated file between 11:30 p.m. and 12:30 a.m. EMC Receipt Report (EMCD6100) for Medicare Part A and Part B X version 4010A1 claim files Production (EMCD6100R01): emc.d36xr.d6100.curhh emc.d36xr.d6100.xzyymmdd New Biller Test (EMCD6100R11): uemc.d36xr.d6100.curhh uemc.d36xr.d6100.xzyymmdd EMC Receipt Report (EMCD6102) for Blue Cross X version 4010A1 claim files Production (EMCD ): emc.d364h.d6102.curhh emc.d364h.d6102.xzyymmdd New Biller Test (EMCD ): uemc.d364h.d6102.curhh REV (5/17/06) 15

19 uemc.d364h.d6102.xzyymmdd EMC Receipt Report (EMCD6102) for Blue Shield X version 4010A1 claim files Production (EMCD ): emc.d366h.d6102.curhh emc.d366h.d6102.xzyymmdd New Biller Test (EMCD ): uemc.d366h.d6102.curhh uemc.d366h.d6102.xzyymmdd EMC Receipt Report (EMCD6102) for QuickLink sm Commercial Institutional X version 4010A1 claim files Production (EMCD ): emc.d368h.d6102.curhh emc.d368h.d6102.xzyymmdd New Biller Test (EMCD ): uemc.d368h.d6102.curhh uemc.d368h.d6102.xzyymmdd EMC Receipt Report (EMCD6102) for QuickLink sm Commercial Professional X version 4010A1 claim files Production (EMCD ): emc.d367h.d6102.curhh emc.d367h.d6102.xzyymmdd New Biller Test (EMCD ): uemc.d367h.d6102.curhh uemc.d367h.d6102.xzyymmdd 997 Acknowledgement for Medicare Part A and Part B X version 4010A1 claim files emc.d36xr.ack997.curhh emc.d36xr.ack997.xzyymmdd uemc.d36xr.ack997.curhh uemc.d36xr.ack997.xzyymmdd 997 Acknowledgement for Blue Cross X version 4010A1 claim files emc.d364h.ack997.curhh emc.d364h.ack997.xzyymmdd uemc.d364h.ack997.curhh uemc.d364h.ack997.xzyymmdd 997 Acknowledgement for Blue Shield X version 4010A1 claim files emc.d366h.ack997.curhh emc.d366h.ack997.xzyymmdd uemc.d366h.ack997.curhh uemc.d366h.ack997.xzyymmdd REV (5/17/06) 16

20 997 Acknowledgement for QuickLink sm Commercial Institutional X version 4010A1 claim files emc.d368h.ack997.curhh emc.d368h.ack997.xzyymmdd emc.d368h.ack997.curhh emc.d368h.ack997.xzyymmdd 997 Acknowledgement for QuickLink sm Commercial Professional X version 4010A1 claim files emc.d367h.ack997.curhh emc.d367h.ack997.xzyymmdd emc.d367h.ack997.curhh emc.d367h.ack997.xzyymmdd 997 Acknowledgement or TA1 Acknowledgement for Medicare Part A X version 4010A1 claim status requests emc.d0302.x276ack.curhh emc.d0302.x276ack.xzyymmdd uemc.d0302.x276ack.curhh uemc.d0302.x276ack.xzyymmdd 997 Acknowledgement or TA1 Acknowledgement for Medicare Part B X version 4010A1 claim status requests emc.d0304.x276ack.curhh emc.d0304.x276ack.xzyymmdd uemc.d0304.x276ack.curhh uemc.d0304.x276ack.xzyymmdd Confirmation Report (EMCDC060) for HIPAA X version 4010A1 claim files and X version 4010A1 claim status requests emc.d9999.dc060.curhh emc.d9999.dc060.xzyymmdd uemc.d9999.dc060.curhh uemc.d9999.dc060.xzyymmdd Outbound Files that are Available as Dated Files Only Medicare Part A Inbound Reject Report (HB997ZRJ-A) and Inbound Accept Report (HB997ZAC-A) for X12 version 4010A1 837 claim and X claim status request files emc.d0619.matran.xzyymmdd REV (5/17/06) 17

21 uemc.d0419.matran.xzyymmdd Medicare Part A FISS 050 Report for X version 4010A1 claim files uemc.d0618.ma050.xzyymmdd Medicare Part B Return Report for X version 4010A1 claim files emc.d0616.mb7i6.xzyymmdd uemc.d0616.mb7i6.xzyymmdd Commercial Institutional R022 Provider Daily Statistics Report for X version 4010A1 claim files (available for production files only; report will be returned from WebMD the next business day after the Empire processing cycle) emc.d0664.r022.xzyymmdd Commercial Professional R022 Provider Daily Statistics Report for X version 4010A1 claim files (available for production files only; report will be returned from WebMD the next business day after the Empire processing cycle) emc.d0663.r022.xzyymmdd Blue Cross Remittance X version 4010A1 emc.d0676.rmtbc.xzyymmdd uemc.d0676.rmtbc.xzyymmdd Blue Shield Remittance X version 4010A1 emc.d0675.rmtbs.xzyymmdd uemc.d0675.rmtbs.xzyymmdd Medicare Part A Remittance X version 4010A1 emc.d0692.rmta.xzyymmdd uemc.d0692.rmta.xzyymmdd Medicare Part B Remittance X version 4010A1 emc.d695b.remtansi.xzyymmdd uemc.d695b.remtansi.xzyymmdd REV (5/17/06) 18

22 Medicare Part A X version 4010A1 Claim Status Response emc.d0586.x277.xzyymmdd uemc.d0586.x277.xzyymmdd Medicare Part B X version 4010A1 Claim Status Response emc.d0588.x277.xzyymmdd uemc.d0588.x277.xzyymmdd Medicare Part B X version 4010A1 IG Edit Report emc.d0588.mb277ig.xzyymmdd uemc.d0588.mb277ig.xzyymmdd Medicare Part A X version 4050 Unsolicited Request for Additional Information (available for production files only) emc.d0587.reqa.xzyymmdd Medicare Part B X version 4050 Unsolicited Request for Additional Information (available for production files only) emc.d0589.reqb.xzyymmdd REV (5/17/06) 19

23 HOW TO ACCESS EMPIRE OMNIPRO sm WITH TN3270 EMULATION The Empire OMNIPRO sm application is part of Empire's mainframe. Before you can access OMNIPRO sm, your TN3270 emulation session must be configured to communicate with Empire's mainframe. Since emulation programs vary slightly between manufacturers, below are guidelines to assist you in configuring the TN3270 session: Session Type: TN3270 Host Name: If dial-up, type: OR If dedicated line, type: nnn.nnn.nnn.nnn (Variable number; will be supplied for each dedicated line) Port Number: 23 LU Name: (not applicable - leave blank) Use TN3270E Protocol: No After you have configured the TN3270 emulation session, activate a session to Empire. The following screen should appear: BCBS10 /EEEEEEEEE /MMM /MMM /PPPPPPPP /I I I I I I I I I /RRRRRRRR /EEEEEEEEE EE / MM M M MM PP /PP / / I I / RR / RR EE / EE MM M/ MM PP PP I I RR RR EE EEEEEEE MM / MM PPPPPPPP I I RRRRRRRR EEEEEEE EE / MM MM PP / I I RR\ RR / EE / EE MM MM PP I I RR \ RR EE EEEEEEEEE MM MM PP /I I I I I I I I I RR \ RR EEEEEEEEE / / / _/ / _/ / _/ / / / _/ / _/ / / WARNING: The unauthorized use of any Empire computer, data, or computer service and unauthorized possession, duplication of or tampering with any computer data or program are criminal offenses. ** ALL VIOLATORS ARE SUBJECT TO PROSECUTION ** IP ADDRESS: nnn.nnn.nnn.nnn Enter selection ===> At the Enter selection prompt, type the letter "O" (for OMNIPRO sm ). Press Enter to display the Empire OMNIPRO sm logon screen (see next page). REV (5/17/06) 20

24 OOOOOO MM MM NN NN IIIIII PPPPPPP RRRRRRR OOOOOO OO OO MMM MMM NNN NN II PP PP RR RR OO OO OO OO MMMMMMMM NNNN NN II PP PP RR RR OO OO OO OO MM MM MM NN NN NN II PPPPPPPP RRRRRRRRR OO OO OO OO MM MM NN NNNN II PP RR RR OO OO OO OO MM MM NN NN II PP RR RR OO OO OOOOOOO MM MM NN NN IIIIII PP RR RR OOOOOO WARNING: The unauthorized use of any Empire Blue Cross Blue Shield computer, data or computer service and unauthorized possession, duplication of or tampering with any computer data or program are criminal offenses. *** ALL VIOLATORS ARE SUBJECT TO PROSECUTION *** Enter User ID -> Password -> New Password -> (enter twice) -> Good Afternoon! PA1 key will release your terminal from CICS. Date: MM/DD/YY Time: HH:MM:SS Applid: CICSPEMC Terminal: V Printer: NONE At the Enter User ID prompt, type in your Empire OMNIPRO sm logon ID. (Your cursor will automatically advance to the next line) At the Password prompt, type in your Empire OMNIPRO sm password. Press Enter to display the OMNIPRO sm Selection Menu. Note: Every 60 days, the OMNIPRO sm password will expire and a new password must be chosen. To change your password: At the Enter User ID prompt, type: your Empire OMNIPRO sm logon ID (Your cursor will automatically advance to the next line) At the Password prompt, type: your Empire OMNIPRO sm password Tab to the New Password prompt, type: a new password of 5 to 8 characters Tab to the Enter twice prompt, retype: your new password Press Enter Suspended Logons An OMNIPRO sm logon that is not used for 120 days will automatically be suspended. To unsuspend a logon, please contact the Integrated Electronic Services (IES) Technical Help Desk (see Technical Assistance). If the IES Help Desk is not contacted to reinstate a logon within 60 days of the suspension date, the logon will automatically be deleted from the system. Once the logon has been deleted, a new OMNIPRO sm Logon Form (SMC1016) must be submitted to request access. REV (5/17/06) 21

25 TECHNICAL ASSISTANCE Please contact the Integrated Electronic Services (IES) Technical Help Desk at (866) , Monday through Friday, 8:30 a.m. - 4:30 p.m. for assistance. REV (5/17/06) 22