Supported Electronic Claims Clearing Houses

Datatel Solutions, Inc supports the Availity Clearing House, and keeping up with technological advances we have established Real Time Claim Submission for Humana, Aetna and Cigna which is integrated within our software. We have also implemented new transmission protocols to support encrytped channels for integrated EDI electronic submissions. It is our hope that by utilizing the services offered by our clearinghouse partner, Datatel Solutions can continue to provide low cost claim submission for all Physicians.

For additional information and documentation please look at our Useful Links page

Electronic Claims Transmission (ECT)

MOMS AT includes a module known as ECT. This module allows for the claims upload to be uploaded via Internet through supported protocols for secure transmission. If you do not have internet that is not a problem! through this same module we allow transmission via modem as well. This technology is integrated within our software so no other third party transmission programs is required.

Electronic Claims Response Module (ECM)

Sending the claims is only one tedious task, a more difficult problem that users face is reading and interpreting response reports. MOMS AT makes this task easy, by reading the response reports for you. Using the ECM module you can quickly filter out Rejected Claims so that they can be addressed while leaving your accepted claims alone. The ECM module tracks all Electronic claims, accepted or rejected until a Payment is Received for the claim. After an Insurance Payment has been Posted MOMS AT clears the claim from the ECM so your ECM module only contains pending claims.

Electronic Remittance Notice - Payment Posting (ERN)

The ERN Module is designed to take HIPAA Compliant 835 transactions and organize them by Payer and Check. When a check is received the user can then enter the ERN module and quickly post the check. A report is generated to confirm the amount of money posted, if any payments could not be posted due to discrencies they would be easily identified on the report for manual consideration.

Electronic Claims in Batch

The MOMS AT Electronic Claims Tracking module contains integrated claims transmission eliminating the need for using an external program, such as, Hyperterminal. Additionally claims are sent over the internet using Industry Standard encryption techniques that prevent unauthorized access to sensitive health data.

Features and Benefits

• ANSI X12 4010 837 Professional and Institutional Claims - HIPAA Compliant claims for compatibility and reliability.
• ANSI X12 835 Electronic Remittance Advice - Receive ERA for select payers including Blue Cross Blue Shield and Medicare.
• An Add-On Module is Required for MOMS AT to make use of 835 ERN Data.
• Internet Claims Transmission - Fast and secure.
• Free Claim Submission - Providers pay no fees to submit commercial claims through Availity, additionally providers that submit commercial claims can also submit supported government payers at no additional cost.

Learn more about Availity by visiting their web site at www.availity.com.

Availity Real Time Claims

Datatel Solutions, Inc. is pleased to announce the immediate availability of the Availity Real Time Claim Adjudication interface for MOMS AT customers. This interface is available to all new and existing MOMS AT customers with the latest version of the MOMS AT software.

Using the Availity realtime interface claims may be submitted seconds after coding them. The insurance company will send back a quick reponse to let you know if the claim is accepted and payment for the claim will be delivered in the following payment cycle.
The average turn around time is about 19 seconds.

Supported Features

• ANSI X12 837 - Real Time Claims
• ANSI X12 270/271 - Real Time Eligibility and Benefits

Supported Payers

• HUMANA

Availity is currently working on adding additional payers. Please visit their website for more details.

MOMS AT Real-Time

837 Transmissions Medical Office Management System - Advanced Technology or MOMS AT is a versatile Practice Management that provides fast and efficient methodologies for 837 submission and tracking. Within 30 seconds from the time of connecting to Availity, encoding and transmitting the claim, a response will be returned. Therefore, the patient liability amount will be present at the time of check out. To accomplish this task we use the HTTPS protocol along with a 128 bit encrypted tunnel using Secure Socket Layers.

Eligibility To extend our versitliy, the MOMS AT real-time engine is used to provided fast access to patient's eligibility. Like our 837 claim submission and 30 second return time, our real-time Eligibility provides the same speed and ease of use. To increase ease of use, we have added access through our Appointment scheduler. The response will be denoted by a small square beside the appointments and the colors will correspond to our Eligibility Tracking system. Eligiblity Manager