Oct 2006
ELECTRONIC CLAIMS TO
MEDICARE, MEDI-CAL AND PRIVATE INSURANCE CHOICES:
Zybex EDI Service Order
Form use
this form to fax to client.
Clients can choose from
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OPTION 1:
PER PROVIDER PRICING (no per claim fee) ECS Claim Clearinghouse Service- Commercial Only There is
no "PER CLAIM" charge for electronic claims if paying "per
provider" |
Per Provider Monthly Fee (non C.Maint) |
Per Provider Monthly Fee (Comprehen.Maint
Client) |
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Commercial Carriers ( |
$60 |
$50 |
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Additional Provider |
$30 |
$25 |
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Each Special
Payers (SCMG, SDPMG, DMERC) |
$20 ($75 max) |
$15 ($60 max) |
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ECS Claim Clearinghouse Service- All Payors |
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All Payors (Commercial and Medicare, MediCaid) First Provider |
$90 |
$80 |
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Additional Providers |
$60 |
$50 |
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Setup Charge- Claims Clearinghouse |
$250 |
$200 |
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Additional Providers- Setup Charge |
$ 50 |
$ 40 |
OR CHOOSE BELOW "PER ELECTRONIC CLAIM" PRICING
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OPTION 2:
"PER CLAIM" PRICING (no mo. provider fee) ECS Claim Clearinghouse Service- Commercial Only There is
no "MONTHLY PER PROVIDER" charge for electronic claims if paying
"per electronic claim" |
Per ECS Claim Fee |
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Commercial Carriers (Aetna, Cigna, Etc) |
$0.35 |
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ECS Claim Clearinghouse Service- All Payors |
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All Payors (Commercial and Medicare, MediCaid) |
$0.25 |
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Setup Charge- Claims Clearinghouse (No Maint/C.Maint Price) |
$250/$200 |
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Additional Providers- Setup Charge(No Maint/C.Maint Price) |
$ 50/$40 |
OTHER OPTIONS AND
SERVICES AVAILABLE
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ONE TIME
'PURCHASE" MEDICARE NEW SOFTWARE & SETUP (This does not apply
for clients submitting Medicare through clearinghouse options above, only for
those that wish to submit direct). |
Non C.Maint |
Comp.Maint |
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Medicare
New Software- ANSI-837 Format (Oct. 2002) |
$900 |
INCLUDED |
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Printing
Services |
Fee per Statement |
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Patient Statements, includes outgoing and return envelopes, 1st
class postage (Custom Forms require
additional fees- Request quote) |
$.59 1-499 stmts. $.58 501-3000 stmts, $.56 3000+; $.20 ea add’l sheet |
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Statement Form Setup
Charge |
$200 |
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EOB
Remittance Posting Service |
Per
Provider Monthly
Fee |
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Medicare- 1st
Provider |
$80 1st provider |
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MediCaid- 1st Provider |
$80 1st provider |
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Commercial- 1st Provider (Only if available) |
$80 1st provider |
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Additional Providers/Each Service |
$40 add’l prov |
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Each Special Payors per
Provider ( |
$15 ($60 max) |
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(Purchase
Alternative: $300 per provider and $20/& $10 per monthly maintenance 1st
provider/addnl. providers |
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Browsable Reports, Close, Compress |
Monthly
Fee |
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1: Close Patient Accounts
to a Browsable CD Rom * 2: Compress Patient
Activity to a Browsable CD Rom * |
Per run $300 1st
Provider $50 ea additional |