Knowledgebase : > ACC eClaims

ACC are decommissioning their eBusiness Gateway.  This means all electronic invoices need to be submitted through their portal via either the SPM or PHM applications.

The ACC portal replaces their Java applet that was used to attach and upload the invoice files to ACC.  To connect to the ACC portal, the Incisive application uses an API (application programming interface).  This is available in more recent versions of the application (410.6 and above).

To check whether you have this capability, check whether you have the option for ACC Online (even if it is dimmed) in Setup - System - ACC Online.  If not, you will require an update.  If you do, you may still benefit from a more recent version.

If you have a version capable of interacting with ACC through our API, then you will need to carry out the following steps:

Permissions in Incisive

  1. To configure the ACC portal upload function
    1. Grant menu permissions via Setup > Personnel > Permissions to give the relevant Role(s) to access to the following menu item:
      Setup > System > ACC Online
      We would recommend that this is only given to a SysAdmin role

  2. To submit invoices to the ACC portal
    1. Grant permissions to Roles (as applicable) to ACC Online functions:
      Office > Invoices > ACC Query
      Office > Receipts > ACC Payments
      Office > Schedules > ACC Query
  1. Log out and back in for new permissions to take effect.

Enable ACC Online

Enabling the ACC Online function will disable the ability to export the invoice as a file.

  1. Setup > System > ACC Online > Enable.
  2. Set Environment to ‘Production’.
  3. Save the settings.

Note: Only enter the Certificate Path and Password on this screen if you have a single Practice certificate to be used by ALL operators.  If you are using individual HealthSecure digital certificates, leave the Path and Password fields blank.

Enabling the ACC API will be for ALL Providers in the database.  Make sure they are ready and have manually uploaded any existing invoice files.

Digital Certificate(s)

ACC require you to have a current HealthSecure digital certificate to be able to connect and upload to their portal.  This needs to be updated annually.

Copy the files from your HealthSecure digital certificate (supplied by Healthlink) to a location on either the local computer or server.

Our recommendation is to create a ‘Certificates’ folder off the \Spmwin\ACC  folder on your server.

For Incisive inCLOUD clients, a ‘Certificates’ folder can be created on the Incisive Files mapped drive e.g. create the folder off your   \\incisivefiles\practice\ACC   folder.


Operator Configuration

Each Operator who will be using the ACC Online function to upload claims to ACC will need to configure their settings:

  1. Setup > Operator > Settings > Edit.
  2. Enter HealthSecure Certificate Path (including name of certificate). We recommend a copy and paste of the path, rename the file and copy the name.
    e.g.  C:\spmwin\ACC\Certificates\Firstname Lastname_1847272768.pfx
  3. Enter the HealthSecure Certificate Password (provided to you by Healthlink).


ACC Regulations

If you are claiming under the ACC Regulations contract for any services that are based on time, you will need to edit each of the relevant services and set the Time variable as applicable.

Setup > Financial > Charges > Schedules > ACC Regulations



Terms and Conditions of using the ACC API

ACC require that we convey the following information to you, regarding your use of the ACC API:

  1. Incisive Software are to be the initial point of contact with regards user service desk requests;
  2. Incisive Software will escalate any issues to ACC, if appropriate; and
  3. Incisive Software will keep you regularly informed. This will be via the News feed in the Message Centre.


ACC are imposing a mandatory integration for your business to interact directly with their systems.

These demands have required substantial investment by Incisive for development and also for the future support services that ACC requires us to provide to you (see above).   Incisive have made direct requests to ACC for financial assistance to lessen the development and considered future support costs, but this has been rejected. 

As a direct consequence of ACC’s intransigence on this issue, your usage of the Incisive functions to interact with the ACC API portal may be reflected with a change to the monthly charge.  This is a cost-of-business to work with ACC.  We recommend that you factor this into the renegotiation of your contracts with ACC.

If your electronic claim(s) are Rejected by ACC using their File Upload Applet (see below), carry out the steps below to troubleshoot and identify the issue(s):

Locate the response file

  1. Navigate to the ACC mapped drive, normally W: and then to the following folder:

    W:\ACCSend\eform\failed

  2. Sort the files by Date modified to locate the most recent files.



  3. Open the .response file.

  4. Look through the file to locate the ,Error> segments.  There may be more than one.

    Some examples to the type of errors are below:





  5. Take note of the various responses.  Then amend the underlying data in the database.

  6. If necessary, you will need to open the XML file that failed to upload.  In the example above, this is the larger file, without the .response on the end.

  7. Search for the relevant schedule lines that contain the error.  Ctrl + F will bring up find and you can then search for the text (example below):



    <schedule_line_number>14

  8. This will identify the Claimant that there is an issue with.

Possible Error messages and potential solutions

There are numerous error messages, but some of the most common ones are as follows:

Accident date must be on or before today

An incorrect date of accident has been entered for one of the claimants.  Locate the appropriate line in the file that was rejected to identify the patient, i.e. <schedule_line_number>14.  

Correct the date of accident in the patients file (Patient - Claim).

Either service code, contract number or service date is invalid

Service Code

Check that you are using a valid ACC Service Item Code (Alias Code).   Only valid ACC Service Item Codes will be accepted for uploading.  A single incorrect entry will result in the whole schedule being rejected.

The Item # field in SPM is used to populate the Service Item Code in the ACC field.

In the XML file, this is preceded with:

<service_item_code>

Please refer to your ACC Contract for a full list of the Service Item Codes to check that you are using the correct code(s).

Solution:

1. Correct the service code in Incisive by editing the entry concerned via:

    • Setup - Financial - Charges - Invoice Items or;
    • Setup - Financial - Charges - Schedules - Third Party Schedule Claim Items.
    • Ensure the Item # field contains the ACC Service Item Code (example below for Moonboot).

2.  Recreate the XML file via Office - Schedules - Process - option 2 Original Schedule.

Contract number

If this error is repeated for each line of the claim, then it is most likely that the Contract number being used to submit the claim is incorrect.

Locate the file that was rejected and find the following segments in the message:

<vendor_acc_identifier>

<contract_acc_identifier>

Note the details used and check that these are correct against your contract (and for the date of the services you are claiming).

Solution:

1. Amend the contract details configured in Incisive by editing the relevant contact: 

    • Setup - Contacts - Invoice / Reports or;
    • Setup - Contacts - Third Party Schedules.
    • Ensure you have the correct Contract Number recorded for the service dates you are trying to claim.

2. Recreate the XML file via Office - Schedules - Process - option 2 Original Schedule.

Service Date

Your ACC Contracts are date dependent.  On the 1 July 2021 your ACC Clinical Services Contract number will have changed for services provided on or after 1 July. 

    • Check the date(s) of the services that you are claiming for.
    • Do not mix pre 1 July services with post 1 July services.
    • Check that you have entered a valid service date.

Once you have identified the issue(s) you will need to correct as follows:

Wrong Contract number used for services claimed:

Amend the contract details (see contract number above) and recreate the XML file (see above).

Once the newly created files are correctly uploaded, amend your contract details.

Schedule contains a mix of dates (pre and post 1 July):

You will need to recreate your schedule and split it in two.

1.Use the Resubmit option in Office - Schedules.

    • This will copy all entries on your current, failed schedule to a new schedule.

      Either:
    • Edit the new schedule and place relevant services on hold (i.e. post 1 July) and/or;
    • Delete the incorrect services and enter correctly.

2. Process the new schedule.

3. Credit all items off the original schedule.

4. If you placed items on hold, after processing these will be moved onto the next new schedule.

The original program specifications from ACC stipulated that a claim, once uploaded to the ACC website, could not be deleted unless it has been 'declined' by ACC.

If there is a problem with what has been uploaded to ACC, i.e. an incorrect procedure has been claimed, it is therefore best to have ACC 'decline' the claim.   You can then download the ACC Remittance Advice with the decline and then import the remittance advice into the database, it will then allow you to delete the invoice. 

If you cannot do this, then you need to locate the file that was uploaded to ACC and move it (cut and paste) back into the folder where the files are placed waiting to be uploaded

\\...\AccSend\eform\Upload     (files that have been uploaded are in here)


\\...\ACC\AccSend\eform         (files waiting to be uploaded are in here)

You will then need to open the files uploaded (sort by date) to try and find the correct one.  Alternatively, you can use the 'Decipher XML' option (Utilities - ACC eForms) to try and find the name of the correct file, just navigate to the Upload folder to start with.  Once you know the name of the file, cut and paste it back one level to the eform folder.


Another alternative option that sometimes works is to recreate the XML file.  This can be done by highlighting the invoice and selecting 'Resend'.  Once the XML file has been created, then delete the invoice.  This must be done before the XML file is uploaded to ACC, so do not have the ACC applet running while carrying out this process.

 

We are starting to see more and more cases where ACC is reversing out payments previously made.

On the Payment Advice Summary that you receive from ACC, these will show in the Amount Paid column in open brackets () with a Comment, such as ‘claimed within 6 weeks of surgery – paid in error’.

The Payment Advice Summary will look something like this.

Payment Advice Summary

Invoice Number

Date

Amount  Invoiced

Amount Paid (incl GST)

GST Paid

AB00000010A

31/10/15

 444.47

 444.47

  57.98

AB00000005A/R4

30/07/15

(127.85)

(127.85)

(16.68)

Comment: claimed within 6 weeks

 

 

 

 

 

Grand Total

 

 

 

$316.62

 

$41.30

 

Currently it is not possible in the Incisive application to put through reversal entries against either a schedule or an invoice.

We suggest that you handle the Payment / reversals as follows:

  1. Ascertain the actual amount paid by ACC. This should appear as the Payment Amount located in the top right hand corner of the Payment Advice Summary and also the Grand Total.

  2. Add up the amounts that have been reversed off.

  3. Add this to the Payment Amount.

  4. Receipt this amount (ensure you enter the receipt with the payment date, not todays date) and allocate the total amount to the various schedules of invoices paid.

  5. Enter an ‘Other Receipt’ as a negative amount for the amount ascertained in (2) above. Code this to an appropriate Income Category creating a new one if necessary, i.e. ACC Reversals. Please refer to the online manual on how to enter ‘Other Receipts’ if you are not sure of this step.

  6. Enter a financial comment against each patient that has had a previous payment reversed; include the amount of the reversal and the reason.

  7. Reconcile the amounts allocated to each schedule, paying off the appropriate claims.

Based on the example above, the figures would be as follows:

1.            

$316.62

 2.

$127.85

 3.

$316.62+$127.85=$444.47

 4.

$444.47

 5.

-$127.85

Issues with uploading invoices to the ACC applet should be referred to ACC eBusiness by emailing:

ebusinessinfo@acc.co.nz

However, if there is an issue with the ‘run applet’ button, this usually suggests that Java hasn’t been installed as this is a Java applet (or Java has inadvertently been removed).

To check if you have Java, you can do this via their website www.java.com as they have a button called ‘Do I have Java?’.

If you don’t have it installed, you can also use this website to download it. It is a free download.