|
Version |
Pertains To |
Symptom |
Resolution |
Date Released |
| 2.15 |
All claim forms |
PES currently sorts the
Client ID and Provider ID lists and drop-down boxes
numerically. Providers prefer alphabetical sorting. |
Sort on Last Name
(primary), then First Name (secondary); make this the
default sort setting. |
12/16/05 |
| All claim forms |
PES currently allows
providers to download 835’s and 997’s only one time.
This is problematic if providers want repeated access to
their 835’s and 997’s, or if their modem disconnects
during download of these files. |
Allow PES the ability to
redownload 835’s and 997’s. |
12/16/05 |
| 2.14 |
Professional |
On the Detail Report, PES
maps the Medicare tab’s right set of Adjustment Group
Codes/Reason Codes drop-down boxes incorrectly; it
reports rows 1-3 into rows 4-6 and vice versa. |
Map the Adjustment Group
Codes/Reason Codes from the Medicare tab correctly, so
that each row and value is reported as it exists on a
claim. |
9/23/05 |
| Dental |
PES accepts G (Gingival) in
the Surfaces drop-down box, causing a HIPAA Level 1
error that rejects the transaction since G is not a
valid HIPAA code. |
Delete G from the
Surfaces drop-down box on the Srv 1 tab to prevent the
HIPAA level 1 error. |
9/23/05 |
| Archive |
PES currently only allows
two digits in the ‘Archive forms at least’ field shown
when creating an archive. |
Increase the ‘Archive forms
at least’ field to allow three digits. |
9/23/05 |
| All claim forms, except
Dental |
PES alphabetizes the Other
Provider list by Last/Org name, but doesn’t alphabetize
the SSN/Tax ID drop-down box list that contains the same
providers. This is confusing for providers, who prefer
alphabetized lists. |
Alphabetize the SSN/Tax ID
drop-down box list by Last/Org Name on Hdr 2. |
9/23/05 |
| All claim forms |
PES requires providers to
enter all fields of information in the Policy Holder
list, including all address fields. This is tedious for
providers. |
On the Policy Holder list,
after the Client ID is entered, populate the Policy
Holder address fields with the Subscriber Address fields
from the Client ID list if the Client ID is recognized.
|
9/23/05 |
| All claim forms |
PES currently sorts claims
in the order they were created, submitted, and/or
restored. Providers prefer alphabetical sorting. |
Sort on Last Name
(primary), then First Name (secondary); make this the
default sort setting. |
9/23/05 |
| All claim forms |
PES currently does not
accept hyphens in the Last Name field for Client, Policy
Holder, Provider, and Other Provider lists. |
Allow hyphen as a possible
character for the Last Name field in Client, Policy
Holder, Provider, and Other Provider lists. |
9/23/05 |
| 2.13 |
Professional |
PES allows spaces to be entered in the
state and country fields causing a HIPAA Level 1 error
that rejects the transaction. |
Trim spaces from the state
and country fields to prevent the HIPAA Level 1 error. |
4/29/05 |
| Outpatient |
PES accepts only five value codes and
amounts; End-Stage Renal Disease (ESRD) claims require
processing of up to 10 value codes and amounts. |
Add five value codes and
amounts so there are ten total value codes and amounts;
this will accommodate ESRD claims processing. |
4/29/05 |
| All claim forms |
Currently, there is no
safety verification message when users select the "Undo
All" button; all changes are immediately undone. |
Display a pop-up
confirmation message where users must confirm before
changes are undone. |
4/29/05 |
| All claim forms |
Each time users select on
"F" or "A" status claims, pop-up messages display. |
Add the text “Do you want
to be notified of this condition in the future?” If
"No" is selected, future message boxes will not display. |
4/29/05 |
| All claim forms |
The Other Provider list
sorts numerically by SSN/Tax ID. |
Sort the Other Provider
list alphabetically by Last/Org Name. |
4/29/05 |
| All claim forms |
The Policy Holder list
sorts numerically by Client ID. |
Sort the Policy Holder list
alphabetically by Last Name (primary) and First Name
(secondary). |
4/29/05 |
| All claim forms |
The Policy Holder ID Code field only
accepts up to 11 characters, while MMIS accepts up to 16
characters. |
Expand the Policy Holder ID
Code field to accept up to 16 characters. |
4/29/05 |
| 2.12 |
All claim forms |
PES accepts HIRSP claims,
and EDS will no longer be processing HIRSP claims. |
Delete HIRSP from the
Program drop-down boxes on Hdr 1. |
3/18/05 |
| Institutional and
Professional claim forms |
PES lists F2 (International
Unit) in the Basis of Measurement drop-down boxes.
However, Wisconsin Medicaid does not accept the "F2"
value. |
Delete F2 from the Basis of
Measurement drop-down boxes on the Srv tab on
Institutional claim forms, as well as on the Srv 1 tab
on the Professional claim form. |
3/18/05 |
| 2.11 |
Professional |
PES allows spaces to be
entered in the state and country fields causing a HIPAA
Level 1 error that rejects the transaction. |
Trim spaces from the state
and country fields to prevent the HIPAA Level 1 error. |
1/21/05 |
| Outpatient |
PES accepts only five value
codes and amounts; End Stage Renal Disease (ESRD) claims
require processing of up to 10 value codes and amounts. |
Add five value codes and
amounts so there are ten total value codes and amounts;
this will accommodate ESRD claims processing. |
1/21/05 |
| All claim forms |
Currently, there is no
safety verification message when users click the "Undo
All" button; all changes are immediately undone. |
Display a pop-up
confirmation message where users must confirm before
changes are undone. |
1/21/05 |
| All claim forms |
Each time users click on
"F" or "A" status claims, pop-up messages display. |
Add the text "Do you want
to be notified of this condition in the future?" If
"No"
is selected, future message boxes will not display. |
1/21/05 |
| All claim forms |
The Other Provider list
sorts numerically by SSN/Tax ID. |
Sort the Other Provider
list alphabetically by Last/Org Name. |
1/21/05 |
| All claim forms |
The Policy Holder list
sorts numerically by Client ID. |
Sort the Policy Holder list
alphabetically by Last Name (primary) and First Name
(secondary). |
1/21/05 |
| All claim forms |
The Policy Holder ID Code
field only accepts up to 11 characters, while MMIS
accepts up to 16 characters. |
Expand the Policy Holder ID
Code field to accept up to 16 characters. |
1/21/05 |
| 2.10 |
Archive files |
Archive files cannot be
restored if the main database has been upgraded after
the archive. |
This upgrade will convert
archived files to current database format at the time a
restore is performed. |
10/15/04 |
| Batch submissions /
Communication log / Reports |
PES users in a network are
unable to identify which user submitted a particular
batch. |
This upgrade will save and
display the logon user ID on the communication log and
claim reports for submitted claims. |
10/15/04 |
| Institutional and
Professional claim forms |
The Medical Record # field
allows special characters; this causes submissions to be
rejected. |
This upgrade will restrict
the Medical Record # field to alphanumeric characters. |
10/15/04 |
| Institutional and
Professional claim forms |
"MJ" (Minutes,
Professional) is an option on these claim forms; this
should not be used. WI policy requires billing in units
or days. |
This upgrade will remove "MJ" from the Basis of Measurement drop-down box on
Professional, Inpatient, Nursing Home, and Outpatient
forms. |
10/15/04 |
| Professional |
"DA" (Days, Institutional)
is an option and causes claims to be rejected. |
This upgrade will remove
"DA" from the Basis of Measurement drop-down box. |
10/15/04 |
| Outpatient |
Providers cannot bill claim
frequency "3" or "4", which is inconsistent with
Medicare’s billing; Medicare allows frequency "3" or
"4". |
This upgrade will allow
entry of "3" or "4" in the last character (frequency) of
Outpatient Type of Bill. |
10/15/04 |
| 2.09 |
Nursing Home |
PES does not allow claim frequencies
"3" and "4" to be billed |
This upgrade allows frequencies "3" and
"4" to be billed. |
7/16/04 |
| 2.08 |
Batch submissions/ Communication
log/Reports |
PES does not display the total billed
amount in the communication log. |
This upgrade displays a total
cumulative billed amount for each claim form billed in
the communication log. |
7/9/04 |
| Help |
The instructions for the M-8 box on the
837 Professional Medicare tab were incorrect. |
This upgrade corrects the help menu
instructions for this field. |
7/9/04 |
| All transmissions |
When performing simultaneous uploads
and downloads, PES considers this to be ONE transaction.
Therefore if an 837 is successful and an 835 and/or a
997 fails, PES displays a "Submission failed" pop up
notification. When a submission fails like this, PES
does not update the submitted claims" status to "F". |
This upgrade will update the claim
status to "F" when this occurs. |
7/9/04 |
| All claim forms |
The policyholder reference list does
not allow for the entry of spaces in the first name
field. |
This upgrade allows for the entry of
spaces in the first name field of the policyholder
reference list. |
7/9/04 |
| 997 Acknowledgements |
There is no easy way to track a
997-acknowledgement back to its respective 837
submission. |
This upgrade will display a tracking
number from the 837 in the 997-acknowledgement and
communication log. |
7/9/04 |
| Professional |
The diagnosis codes are not displayed
on the Srv 1 tab. |
This upgrade displays eight diagnosis
code fields on the Srv 1 tab. These fields are protected
on the Srv 1 tab and simply display the codes entered on
the Hdr 2 tab. |
7/9/04 |
| Nursing Home Outpatient |
PES allows claim frequency "3" and "4"
to be billed on these forms. |
This upgrade does not allow frequencies
"3" and "4" to be billed on these forms. |
7/9/04 |
| All claim forms |
PES does not display entire, long
descriptions in data drop down windows. Users are
required to scroll to view the entire description. |
This upgrade maximizes all data drop
down windows so the whole message can be viewed without
scrolling. |
7/9/04 |
| Dental |
On the OI tab, when a user selects a
carrier code and leaves the other fields blank and then
selects Release of Medicaid Data, PES jumps to the next
tab without allowing the user to complete the remaining
fields. |
This upgrade will not jump to the next
tab until all the fields are completed. |
7/9/04 |
| All claim forms |
PES allows the entry of any year
greater than or equal to 1800. |
This upgrade changes the date
validation to be greater than or equal to 1850. |
7/9/04 |
| InstallShield |
PES does not notify users of the
changes being made in an upgrade. |
This upgrade adds the enhancement
descriptions to the InstallShield program. |
7/9/04 |
| Reports |
Condition Codes are not displayed on
the summary reports. |
This upgrade will display condition
codes on the summary reports. |
7/9/04 |
| Reports |
PES cannot print reports
alphabetically. |
This upgrade sorts reports
alphabetically by last name. |
7/9/04 |
| All claim forms |
If a claim contains multiple service
lines, deleting a service line will cause the pointer to
go back to the first service line. |
This upgrade will set the pointer at
the service line that is just one above the deleted row. |
7/9/04 |
| Help |
The word "Function" is misspelled in
the PES Help Index. |
This upgrade corrects the misspelling. |
7/9/04 |
| Outpatient Professional |
PES only bills claims to Medicaid and
HIRSP. |
This upgrade adds Wisconsin Well Woman
Program (WWWP) as a billable program. |
7/9/04 |
|
2.07 |
Outpatient |
The billed amount field is auto calculated on the
Inpatient, Outpatient, and Nursing Home forms.
The auto calculation results in the total billed
amount not always balancing with the sum of the detail
billed amounts due to rounding. |
This upgrade corrects the rounding error. |
5/10/04 |
|
2.06 |
All transmissions |
PES users are unaware of how long the upgrade process
will take and it appears that PES is not responding
when the user checks the status with Microsoft task
list (Ctrl + Atl + Del). |
This upgrade displays a progress bar when downloading
files/upgrades. The progress bar will not be seen when
downloading the 2.06 upgrade. The progress bar will be
seen when submitting claims or downloading subsequent
upgrades. |
4/2/04 |
|
835 Remittance Advice and 997 Acknowledgement(s) |
PES automatically displays the most recently
downloaded batch response in the "View Batch Response" window, even though the user did
not select to view it. Since large files may take
hours to display this was not efficient. |
This upgrade will not display any batch responses when
the "View Batch Response" window is loaded. The user
can now select the batch response they wish to view by
clicking on the filename. |
997
Acknowledgement(s) |
It is not possible to distinguish a test 997 from a
production 997. |
This upgrade adds a data element that will indicate
whether the transmission is in a "test" or
"production" mode. |
|
All claim forms |
The "Add" command button is misleading because it
creates a new claim form. |
This upgrade changes the "Add" command to say "New" on
all claim forms. |
|
All claim forms |
The policyholder ID code field and the city field
within the client, policyholder, and provider
reference lists do not have a field length minimum
requirement. At least two characters are required to
generate a HIPAA compliant transaction. This causes
batches to be rejected when only one character is
entered in these fields. |
This upgrade requires that at least two characters be
entered in these fields. |
|
All claim forms |
PES does not verify the Service Adjustment Paid Amount
and the sum of Reason Code amounts equal the
detail-billed amount. This causes claims to be denied
due to amounts not balancing. |
This upgrade validates the service adjustment amounts.
An edit will be displayed when the amounts are out of
balance. Any adjustments and paid amounts at the
header level will not be considered. Each service
detail will be individually validated. |
|
All claim forms |
The carrier code drop down lists on the Other
Insurance (OI) and Medicare tabs are inconsistent with
one another, creating the potential for confusion. The
OI carrier code drop down list displays the carrier
code, last name, and client ID. The Medicare
carrier code drop down list displays the carrier code,
last name, and first name. |
This upgrade modifies the OI drop down list to match
the Medicare drop down list. Both lists will now
display the carrier code, last name, and first name of
the policyholder. |
|
All claim forms |
For all address information, PES does not have a drop
down list containing all 50 state two character
abbreviations plus the District of Columbia. |
This upgrade adds a drop down list containing all 50
state two character abbreviations plus the District of
Columbia (DC) for all address information. This list
will default to "WI" when the field is required and to
blank when the field is optional. |
|
All claim forms |
PES currently allows alphanumeric characters in the
SSN/Tax ID field. This field should be numeric only. |
This upgrade restricts the SSN/Tax ID field to only
allow the entry of numeric values. |
 |
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
 |
Dental |
|
|
Professional |
|
|
Other |
|
PES defaults the Claim Filing Ind Code on the Medicare
tab to either "MA" or "MB" depending on the claim
form, but PES does not prevent the user from changing
it to a different value. |
This upgrade eliminates all values from the Claim
Filing Ind code drop down list on the Medicare tab
except for "MA", "MB", and "16". These values are only
values accepted by Wisconsin Medicaid. |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
PES does not allow duplicate entries for other
providers when the social security number (SSN) and
taxonomy codes are identical. Referring providers that
operate as multiple billing providers could have the
same SSN and taxonomy codes. |
This upgrade removes this duplicate restriction. |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
The billed amount is a free forming field allowing the
user to enter an incorrect billed amount that does not
balance with the unit rate and units fields. |
This upgrade auto calculates the billed amount when
unit rate and units are entered. |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
PES requires entry of the discharge hour for interim
billing even though the discharge hour is not needed
for interim billing. |
This upgrade eliminates this requirement. |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
There are two segments that are not being created by
PES on outpatient claims when a provider bills for a
certain revenue code, specifically for emergency or
critical care. |
This upgrade formats these two segments when revenue
code = 0450-0459, 0516, or 0526. |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
The Outpatient form in PES does not have an Edit All
command button. This function is currently on the
Nursing Home form only. The Edit All button allows the
from date-of-service, to date-of-service, and covered
days/units to be modified on all existing "ready"
status claims by the use of this single button. The
Edit All functionality is needed because just like
nursing homes, Home Health providers bill once a
month. |
This upgrade adds an Edit All command button for use
on Home Health Outpatient claims in addition to
Nursing Home claims. |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
PES does not allow late billing on the Outpatient
form. |
This upgrade allows "5" (late billing) as a valid
claim frequency on the Outpatient form. |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
There are two segments that are not being created by
PES on professional claims when a provider bills for a
certain procedure code, specifically for EPO
Injections. In addition, one of these segments
requires the entry of the patient’s weight. |
This upgrade formats these two segments when the
procedure code is in the range Q9920 – Q9940 (EPO).
This upgrade will also create a three character
numeric only, maximum length "Patient Weight" field on
the Professional form. |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
The Dental claim form contains a Service Adjustment
tab, even though other insurance adjustments should
only be reported at the claim header. |
This upgrade removes the Service Adjustment tab from
the Dental claim form. |
|
2.05 |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
PES does not allow entry of a non-person in the
Rendering Provider fields at both the header and
detail for Professional claims. (e.g., a CSP or
Critical Access clinic). |
This upgrade will allow entry of a non-person in the
Rendering Provider fields at both the header and
detail for Professional claims. |
11/21/03 |
|
All transmissions |
Users are able to submit claims without downloading
available upgrades, potentially allowing incorrect
claim submissions. |
This upgrade will not allow users to upload/download
files until all available upgrades have been
downloaded and installed. |
|
All transmissions |
Users are required to call the WIEDI helpdesk or
access the
www.wisconsinedi.org website directly to update an
expired web password. |
This upgrade will allow the user to update the web
password within PES when the web password has expired. |
|
All transmissions |
PES does not have the capability to recover a
forgotten password. As a result, users are not able to
access the PES software. |
This upgrade will allow the user to reset their
password by answering a predefined question. |
|
2.04 |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
When claims
entered in PES contains multiple billing providers
with the same SSNs/Tax IDs, claims may be formatted
incorrectly when sending a file to Wisconsin EDI. |
This upgrade will ensure that all claims are properly
formatted when claims contain billing
multiple providers with the same SSNs/Tax IDs. |
10/31/03 |
|
2.03 |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
PES does not allow a zero to be entered in the billed
amount field. |
This upgrade will allow a zero to be entered into the
billed amount fields. |
10/27/03 |
|
2.03 |
All transmissions |
When a user simultaneously selects both a 837 file to
send and a 835/997 file to receive, PES incorrectly
displays a message indicating a successful
transmission even when the 837 file to send failed.
(The PES communication log, however, indicates that
the transmission of the 837 file failed.)
|
This upgrade will display a message indicating a
transmission failed if either 837 file to send and/or
an 835/997 file for download failed. |
10/27/03 |
|
2.03 |
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
PES displays a whole number in the service line
display box when a value contains a decimal. |
This upgrade will correctly display the decimal in the
service line display box when appropriate. |
10/27/03 |
|
2.02
|
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
PES cannot create a HIPAA compliant
transaction when the unit billed is less than 1. |
This upgrade will create a HIPAA
compliant transaction when the unit billed is less
than 1. |
10/09/03 |
|
2.01
|
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
PES
does not allow entry of the Covered and Non Covered
days field when the Type of Bill = 15x (Intermediate
Care level-I Hospital Crossover). |
This upgrade will require covered days when the
Type of Bill = 15x on the inpatient claims form. |
9/25/03
|
|
2.01
|
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
The Acknowledgment (997) batch response cannot be
interpreted as data and is displayed in a raw data stream. |
This upgrade will format the Acknowledgement (997)
batch response into a readable report. |
9/25/03 |
|
2.01
|
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
When multiple providers have the same SSN/EIN in
the Other Provider Reference list, PES does not allow
the user to select the correct provider.
|
This upgrade will allow the user to select the
appropriate provider when multiple providers have the
same SSN/EIN numbers. |
9/25/03 |
|
2.01
|
|
|
Inpatient |
|
|
Outpatient |
|
|
Nursing Home |
|
|
Dental |
|
|
Professional |
|
|
Other |
|
User unable to enter HIRSP claims in PES. |
This upgrade will allow users to enter HIRSP claims in
addition to Medicaid claims.
Note: This upgrade will convert all claims
previously keyed in PES to default to Medicaid. If
users have entered HIRSP claims prior to this upgrade,
they must manually change the Program indicator on
each claim to HIRSP.
|
9/25/03 |
