AVAPX12 SETUP CHECKLIST

* Indicates Required Field

1. EDI Receiver Setup Availity

Address Tab
* Name Enter a name to identify the receiver, e.g. AVAP.
Street Enter the payers address.
City Enter the payers city.
State Enter the payers state.
Zip Code Enter the payers zip code.
Phone 1 Enter the payers primary phone number.
Extension Enter the payers primary phone extension.
Phone 2 Enter the payers secondary phone number.
Fax Number Enter the payers fax number.
E-Mail Enter information for the payers email address.
Web Address Enter information for the payers web address.
Contact Enter the payers contact person.
Comment Enter a basic comment about the payer.
Modem Tab
Data Phone Leave blank.
Dialing Prefix Leave blank.
Dialing Suffix Leave blank.
Serial Port N/A.
Baud Rate N/A.
Transmit Protocol N/A.
Parity N/A.
Data Bits N/A.
Stop Bits N/A.
Modem Initialization Leave blank.
Modem Termination Leave blank.
FTP Address Leave blank.
FTP Port Number Leave blank.
Dialing Attempt Enter 20.
* Transmission Mode Select Active.
ID Tab
* Submitter ID 1 Enter AV09311993.
* Submitter ID 2 Enter AV01101957.
* Submitter Password 1 When you register with Availity, information on your
password will be given to you.
Submitter Password 2 Leave blank.
* Program File Enter AVAPX12.
File Path If you want to store EDI files in a path other than the default
directory, enter the alternate path in this field. However, if you change the
path, the files may not be included in the backup.
File Name Leave blank.

Group Practice For group practices, check this box to send group IDs.
* Interchange Receiver ID Enter 030240928.
* Interchange Sender ID Enter AV09311993.
Vendor ID If you work with a Value-Added Reseller, enter his/her vendor ID in
this field. If you leave the field blank, the program sends Medisofts vendor ID.
Unique Submission Count This field is used when filing claims for multiple
practices. If you use multiple receivers to send claims, enter a unique two to
five digit numeric ID.
Extras Tab
* Office Contact Enter the name of the contact person in your office.
* Application Receiver Code Enter 030240928.
* Application Sender Code Enter AV01101957.
Region Leave blank.
* Receiver Type Leave blank.
* Entity Type Click the down arrow to select Person or Non-person as the
entity type. This field determines whether billing information comes from the
practice or provider. If you have filled out the Billing Service tab in Practice
Information, the billing service information will be sent no matter what you
select in this field.
Report File Type Leave blank.
Julian Date Leave blank.
Participating Leave blank.
Code Match Leave blank.
Extra 1, 2, 3 Leave these fields blank.
2. Insurance Carrier Setup
EDI/Eligibility Tab
EDI Receiver Select the AVAP module.
EDI Payor Number Enter one of the following payer IDs.
Illinois Medicare
00952
Illinois IDPA
IL621
Michigan Medicare
00953
IL/MI Blue Cross/Blue Shield
00621
Texas Medicare
00900
Texas Medicaid
86916
Texas Blue Cross
84980
New Mexico Medicare
00521
New Mexico Blue Cross
00790
Commercial
Contact Availity for the payer list
For the most current Availity payer list, go to the following web site:
http://www.availity.com/reference_documents.htm