=============================== Welcome to the QHA Network! =============================== Your decision to submit claims electronically is a sound choice which will reduce healthcare costs, while accelerating your claim payments. Our goal is to make your entire electronic filing experience as enjoyable as possible. Here is a brief overview of steps that need to be taken to begin electronic filing with QHA. ================ THE SOFTWARE ================ The QHA Q-Connect EDI Software will enable you to send claims electronically through our QHA EDI Network via modem, cable modem or DSL. If you have at least a 2400 baud Hayes-compatible modem, you are prepared to begin transmitting. We have a toll-free line or internet capabilities which will enable you to transmit 24 hours a day, 7 days a week. Note: If you are going to be using a communication software application supplied by your Vendor, please skip the Configuration section below to the Trial Procedure. You may contact your Vendor to install this software. ================= CONFIGURATION ================= Please call the QHA Software Support Group at 1-800-500-8747 (or locally at 812-468-8477 ) when you are ready to begin the Q-Connect EDI software installation. Q-Connect will not operate properly until you are assigned a USER ID and PASSWORD and the software is properly configured. The QHA Software Support Group will supply this information to you. Please make us aware at the time of installation if you are using a digital or high speed line. ======================= THE TRIAL PROCEDURE ======================= The first transmitted batch of "LIVE CLAIMS" will be a "trial procedure". The trial procedure ensures the following: 1) claims are being properly transmitted, 2) provider numbers are not missing, 3) the system is configured properly. ======================= THE MAPPING PROCESS ======================= Once we have received your file, we begin the "mapping process". This process will take 2 to 4 business days. Once completed, reports for file transmission should be available for pickup the following day. QHA or your Vendor will take you through the first file transfer and report retrieval once reports are made available. ========================= PERTINENT INFORMATION ========================= Before QHA can process your information electronically, please perform the following: 1) Fill out the Provider Information Sheet for each practicing physician. 2) Have each physician sign the Customer Authorization Sheet. 3) Please sign the Closing Document "Electronic Claims & Transaction Service Agreement" for EDI ( Electronic Data Interchange )submission. NOTE: PLEASE MAKE COPIES OF THE CUSTOMER AUTHORIZATION FORM AND PROVIDER INFORMATION SHEETS FOR ADDITIONAL PROVIDERS NOW AND IN THE FUTURE. WE WILL ONLY NEED ONE ELECTRONIC CLAIMS AND TRANSACTION SERVICE AGREEMENT PER FED ID/SOC SECURITY NUMBER YOU WILL BE FILING IN BOX 25 OF THE HCFA FORM. Return these sheets to our company as soon as possible to prevent delays in the handling of your data. This information can be faxed to our company, but the original "Electronic Claims & Transaction Service Agreement" still needs to be mailed. Please make sure it is filled out entirely. If the information is faxed, please submit to: #1-812-468-8478 FAX LINE ATTENTION: ROBYN PAGE QHA EDI SERVICES Mail original of the “Electronic Claims & Transactions Service Agreement” to: QHA EDI SERVICES 201 NW FOURTH STREET SUITE # 111 EVANSVILLE, IN 47708-1356 (Regardless of whether or not you have faxed the information) Once we have received your information along with your first batch file, please allow two to six weeks for your Medicare, Medicaid, and BCBS claims to be filed electronically. If State Payer claims are sent to QHA prior to APPROVAL, these claims will have be sent on paper until carriers are approved. Commercial or private insurance pre-approved for electronic filing.