ABILITY | PC-ACE is updated quarterly. Updates include CMS mandates, new code sets and Blue Cross and Blue Shield of Nebraska-specific changes.

Please note: This build includes the October 2018 Medicare mandate changes, the latest ANSI-837 edits and prepare modules, and several other general and ANSI-related product enhancements. Please download the appropriate newsletters for complete details here.

If you have received an e-mail instructing you to update ABILITY | PC-ACE:

Please keep all third-party software compliant, when applicable, if importing into PC-ACE32 to avoid mapping conflicts with the new CMS 1500 form.

Note the following message from our vendor: PC-ACE Pro32 will continue to support import of the CMS-1500 (08/05) format. However, users who begin printing the CMS-1500 (02/12) format in order to import ICD-10 codes will require a remapping to the new layout.

There is a one-time flat fee per successfully mapped/re-mapped print file. This fee includes delivery of the map and reasonable support assistance to get the map installed and operational.

For additional ABILITY | PC-ACE information, please refer to our EDI documentation.



The percentage of the bill you pay after your deductible has been met.


A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 


The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.


Includes behavioral health treatment, counseling, and psychotherapy

in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)


Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.


If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.


The amount you pay to your health insurance company each month. 

Preventive services

Health care services that focus on the prevention of disease and health maintenance.


Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).


A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.