SELECT ScheduleItems.ScheduleItems_ID, ScheduleItems.Bill_Type, ScheduleItems.Rev_Code, ScheduleItems.HCPCS, ScheduleItems.Visit_Date, ScheduleItems.Total_Units, ScheduleItems.Total_EClaim, Assessment_New.Assessment_Tracker_ID, Assessment_New.Start_of_Care_M0030, Assessment_New.Certification_Start, Assessment_New.Certification_End, Assessment_New.Source_of_Admission, Assessment_New.Admission_Description, Assessment_New.HIPPS_Code, Assessment_New.Medicare_Number_M0063, Assessment_New.Claim_Key, Assessment_New.Information_Release, patient.Patient_ID, patient.Last_Name_M0040, patient.First_Name_M0040, patient.Middle_Initial_M0040, patient.Street_Address, patient.Gender_M0069, patient.City, patient.State_M0050, patient.Zip_M0060, patient.DOB_M0066, patient.MSA_Code, Agency.Agency_Medicare_ID, Agency.Agency_Name, Agency.Agency_Address1, Agency.Agency_City, Agency.Agent_FEIN, Agency.Submitter_ID, Agency.Agency_State, Agency.Agency_Zip, Agency.Agency_Contact, Agency.Agency_Contact_Phone, Physician.MedicareUPIN, Employee.Last_Name as LastName, Employee.First_Name as FirstName, Diagnosis.Text_ICD FROM #Request.prefix_db_agency#.patient INNER JOIN #Request.prefix_db_agency#.Assessment_New ON patient.Patient_ID = Assessment_New.Patient_ID INNER JOIN #Request.prefix_db_lookup#.Agency ON patient.Agency_ID = Agency.Agency_ID INNER JOIN #Request.prefix_db_lookup#.Physician ON patient.Primary_ReferringPhys_ID_M0072 = Physician.Physician_ID INNER JOIN #Request.prefix_db_agency#.Diagnosis ON patient.Patient_ID = Diagnosis.Patient_ID INNER JOIN #Request.prefix_db_agency#.ScheduleItems ON patient.Patient_ID = ScheduleItems.Patient_ID INNER JOIN #Request.prefix_db_lookup#.Employee on Physician.Employee_ID = Employee.Employee_ID WHERE ScheduleItems.ScheduleItems_ID IN (#Form.ScheduleItems_ID#) ORDER BY patient.Patient_ID, ScheduleItems.ScheduleItems_ID ~" & chr(13)& chr(10) & "GS*HC*22*33*#DateFormat(Now(), "YYMMDD")#*#DateFormat(Now(), "HHMM")#*6*X*004010X096A1~" & chr(13)& chr(10) & "ST*837*2222*~" & chr(13)& chr(10) & "BHT*0019*00*000002*#DateFormat(Now(), "YYMMDD")#*#DateFormat(Now(), "HHMM")#*CH~" & chr(13)& chr(10) & "REF*87*004010X096A1~" & chr(13)& chr(10) & "NM1*41*2*#GetData.Agency_Contact#*****46*00*~PER*IC*#GetData.Agency_Contact#*#Left(GetData.Agency_Contact_Phone,3)##Mid(GetData.Agency_Contact_Phone,5,3)##Mid(GetData.Agency_Contact_Phone,9,4)#~" & chr(13)& chr(10) & "NM1*40*2*SELECT PAYER NAME*****46*C00380~"& chr(13)& chr(10) & "HL*1**20*1~" & chr(13)& chr(10) & "NM1*85*2*#GetData.Agency_Name#*****34*#GetData.Agent_FEIN#~" & chr(13)& chr(10) & "N3*#GetData.Agency_Address1#~N4*#GetData.Agency_City#*#GetData.Agency_State#*#GetData.Agency_Zip#~" & chr(13)& chr(10) & "REF*1C*#GetData.Agency_Medicare_ID#~PER*IC*#GetData.Agency_Contact#*TE*#Left(GetData.Agency_Contact_Phone,3)##Mid(GetData.Agency_Contact_Phone,5,3)##Mid(GetData.Agency_Contact_Phone,9,4)#~" & chr(13)& chr(10) & "HL*2*1*22*0~SBR*P*18**UNKNOWN*****MA~" & chr(13)& chr(10) & "NM1*IL*1*#GetData.Last_Name_M0040#*#GetData.First_Name_M0040#****MI*#GetData.Medicare_Number_M0063#~"& chr(13)& chr(10) & "N3*#GetData.Street_Address#~"& chr(13)& chr(10) & "N4*#GetData.City#*#GetData.State_M0050#*#GetData.Zip_M0060#*~DMG*D8*#DateFormat(GetData.DOB_M0066,"yyyymmdd")#*#GetData.Gender_M0069#~"& chr(13)& chr(10) &"NM1*PR*2*Select Payer Name*****PI*C00380~"& chr(13)& chr(10) &"N3*MED*MED~"& chr(13)& chr(10) &"N4*MED*MED*99999~"& chr(13)& chr(10) & "CLM*#GetData.First_Name_M0040# #GetData.Last_Name_M0040#:#DateFormat(GetData.Certification_end,"mm/dd/yyyy")#*000***32>A>9*Y**Y*Y*********Y~"& chr(13)& chr(10) & "DTP*434*RD8*#DateFormat(GetData.Certification_start,"yyyymmdd")#-#DateFormat(GetData.Certification_End,"yyyymmdd")#~"& chr(13)& chr(10) & "DTP*435*DT*#DateFormat(GetData.Start_of_Care_M0030,"yyyymmdd")#~"& chr(13)& chr(10) & "CL1**#GetData.Source_of_Admission#*#GetData.Admission_Description#~"& chr(13)& chr(10) & "REF*G1*#GetData.Claim_Key#~"& chr(13)& chr(10) & "HI*ABK>#GetData.Text_ICD#~"& chr(13)& chr(10) & "HI*BE>61>>>#GetData.MSA_Code#~ "& chr(13)& chr(10) & "NM1*71*1*#GetData.LastName#*#GetData.FirstName#****24*112112112~"& chr(13)& chr(10) & "REF*1G*#GetData.MedicareUPIN#~"& chr(13)& chr(10) &"LX*#ctr_322#~"& chr(13)& chr(10) &"SV2*0023*HC>#Trim(GetData.HIPPS_Code)#*0*UN*#NumberFormat(GetData.Total_Units)#~"& chr(13)& chr(10) &"DTP*472*D8*#DateFormat(GetData.Certification_Start,"yyyymmdd")#~"& chr(13)& chr(10)> #Trim(GetData.HCPCS)#*#NumberFormat(GetData.Total_EClaim)#*UN*#NumberFormat(GetData.Total_Units)#~"& chr(13)& chr(10) &"DTP*472*D8*#DateFormat(GetData.Visit_Date,"yyyymmdd")#~"& chr(13)& chr(10)> UPDATE #Request.prefix_db_agency#.ScheduleItems SET EClaimed = 1 WHERE ScheduleItems_ID = #GetData.ScheduleItems_ID#

Agency Administration - Claims Ready for Export to PC-ACE

Your Claims have been prepared for export. Right click on the hyperlink
below and click Save Target As...

Save as power.dat in c://winpcace/impub92