Electronic ACC Claiming

Abstract

It is possible to exploit facilities made available by New Zealand's Accident Compensation Commission (ACC) to submit claims electronically.  This removes the need for any paper based submissions, and speeds payment significantly.  This knowledgebase article explains how to configure and use this service.

Underlying challenge

In order to submit claims electronically, the following criteria must be met:

1. The office needs an internet connection.  Broadband is preferred.
2. The office needs to have Capable 21C configured so that patients are invoiced correctly when claiming from ACC. Refer to Intermediate Training for more information about configuring Capable 21C for ACC Claiming.
3. The office needs to record the appropriate entries on patient files.
4. The office needs to contact ACC and liaise with them to get special ACC online software installed and configured (supplied and supported by ACC - takes approximately 30 minutes over the phone).
5. The office needs to have a copy of the special ACC Extract tool developed by Capable Software Pty Ltd in conjunction with City Chiropractic in Auckland.  This tool is an Excel Spreadsheet, and will only work if Microsoft Excel (tm) is installed.

See the resolution section below for more detail about meeting these requirements.

Resolution

How it works

The procedure for submitting claims is quite easy.

1. Patients are invoiced normally using Capable 21C.
2. At regular times (eg once a week), an ACC Submission is prepared using the Extract Tool provided by Capable Software Pty Ltd.
3. This submission is loaded into the special tool supplied by ACC.
4. The ACC tool transfers the claim to ACC.

The eBusiness Team at ACC provide documentation, support and training on how to use the special ACC tool, and can also explain what happens to the claims once the tool has transferred them to ACC.

Configuration of Capable 21C

The following items must be configured correctly within Capable 21C.

1. ACC patients must be invoiced for two line-items each time they have a claimable visit.  One of these should be the ACC Claimable component of the visit.  The other is the patient payable component (or gap).
2. The line-item for the ACC Claimable component should be named in accordance with ACC's requirements, should have an ACC endorsed Item Code and should be priced appropriately (at the time this article was written, the standard price for a Chiropractic Consultation was $24.48).
3. The practitioners should have a valid ACC approved Provider Code recorded in their setup screen.

Recording Entries on Patient Files

Aside from appropriate invoicing, ACC patients should also have:

• An Insurance Claim number recorded in their Patient Details (on the Insurance tab).
• A Date of Accident recorded in their Patient Details.
• An ACC approved Diagnosis recorded in their Patient Details.
• An ACC approved First name, Surname and Date of Birth

Special ACC-Supplied Electronic Claiming Tool

At the time this article was written, the tool supplied by ACC is called XML Builder.  It was developed by the eBusiness Team at ACC.  The chief engineer at the time was Manjita Prakash (Manjita.Prakash@acc.co.nz).

The eBusiness Team at ACC are particularly helpful in installing, configuring and using this tool.  They have worked with Capable Software clients in the past.

Special Capable Software-Supplied Claim Tool

The special tool developed by Capable Software Pty Ltd in conjunction with the staff of City Chiropractic at Auckland can be downloaded from www.capablesoftware.com.au/Patches2/Media/ACCExtract.xls

The tool should be saved somewhere handy, and should be located on the same PC as the Capable 21C database.  When required, the tool can be opened using Microsoft Excel.

To use the tool:

1. Open the tool using Microsoft Excel.  Sometimes Microsoft Excel will be configured to disable Macros.  If this is the case, Excel will report that the Macros are disabled.  In order to enable them, go to Tools|Macro|Macro Security and change the setting to ‘Low’. Then close Excel, restart it and try again.
2. The tool displays the dollar values that will be extracted for claiming.  Make sure that these amounts only include the items to be claimed (eg items with a value of $24.48 - or whatever is the ACC rebate at the time).  Several prices can be nominated (eg $24.48 for adjustments and $30.60 for X-rays).
3. Click the Extract button.
4. The tool will automatically create and save a file that can be loaded by the ACC-supplied XML Builder tool.
5. Close Microsoft Excel, open the XML Builder tool supplied by ACC and follow the instructions supplied by ACC.

Note that assistance and support with the Capable Software Extract tool is available from Capable Software Pty Ltd, but is only available to customers with a current Technical Support Contract.

Detailed Information

Refer to KB-Batch production of M47 Claims for information about submitting claims manually.

Special thanks go to Dr Nick Laurie and the team at City Chiropractic for their hard work getting this tool working smoothly.

Copyright 2008 Capable Software Pty Ltd

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