PC ACE Documentation

Please note: This build includes the July 2016 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.

Reference the documents below to use ABILITY | PC-ACE for uploading claims, sending secondary claims and adjusting or replacing claims.

 

How to Install an Update to PC-ACE

This document provides a printed version of the steps to follow to install an update to ABILITY | PC-ACE. The actual software includes an online “Wise Installation Wizard” that walks you through the installation.

 

PC-ACE Pro32 Release Newsletters

These documents explain all the changes made to the software in the latest update.

 

PC-ACE PRO32 Claims Processing System User’s Manual

This is a printable version of the online HELP documentation that is in ABILITY | PC-ACE. The online HELP file is updated whenever the software is updated, but if you want a paper copy that is up-to-date, you can print this file.

 

A default setting in ABILITY | PC-ACE will trigger the purging of files that have been transmitted. The user can increase or decrease the number of days that files are archived before they are purged.

July 2016 HCPC Changes

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HEALTH INSURANCE TERMS


COINSURANCE

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

COPAY

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. 

DEDUCTIBLE

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.

SUBSTANCE ABUSE DISORDER SERVICES

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.)

out-of-pocket

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

penalty

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.

premium

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.

rehab SERVICES

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).

specialist

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.