Enhanced 835 File
Enhanced 835 File ProcessSummary: Novus enhances the Medi-Cal ANSI-835 file with relevant data from the SCPI/ARDS file. The SCPI/ARDS file is a proprietary file format that Medi-Cal generates each week, and it contains several data elements not found in the 835 version (namely RAD codes). Once imported into the hospital’s Patient Accounting System these extra data elements provide the business office with useful information that contributes to greater efficiency with follow-up process.
- The Super ERA can be downloaded directly from the BillPro application (Fig. 1) or transferred to a secure SFTP location (Fig. 2).
- RAD codes are placed into the MIA, MOA or LQ segments, preceded by the word “RAD”.
- A duplicate Auth Control Number was detected and therefore this latest request is being rejected. Provider must not reuse previous Auth numbers. This typically occurs when the provider responds to a Deferred Auth too late.
- Also, if requested and provided with specs we can split the original 835 file into separate files based on Account#, Provider# or whatever the criteria may be.
- The last two screen shots show how the information can appear in the hospital’s Patient Accounting System (Figs. 3-4).