TERMS
Id number assigned to all billing providers
What is an NPI number?
Houses all Centene Apps
What is Centene Connect (Citrix)?
Used to notifiy the plan that provider is submitting a corrected claim
What is number 7 in box 22?
I can be found in box 21 on lines A-L
What are Dx codes?
You can find Rejected Claim images for claims submitted electronically in which system?
What is NO SYSTEM?
Provides benefits to members with a focus on preventive care
What is an MCO?
Six steps of Ajudication are completed here
What is Amisys?
Can be found in the shaded area in box 24a
What is the NDC number?
I can be found in the shaded area of box 24J, and boxes 32B and 33B, what am I and what is my purpose?
What is taxonomy? I am used to identify the type of provider.
This system holds all Provider EOPs for claims submitted via paper
What is Emdeon?
Benefit combination of Medicare and Medicaid benefits
What is MMP?
System used to locate college information for a specific provider
What is Potico?
Found in box 23 when specific labs are being completed
What is a CLIA number?
Found in box 28, I am required for claim processing
What are Total Charges?
TRUE or FALSE:
Information in box 32 is required
What is False?
All high dollar imaging is approved by this department
What is NIA?
Used on a daily basis to log phone calls, view member and provider info, create tasks
What is OMNI?
A "yes" in this box will require add'l information in boxes 9,9a,and 9d
What is box 11d?
What information is logged in box 23?
What is Authorization number and/or CLIA?
Found in box 24b
What is Place of Service Code?
A set per member, per month payment that MCO's receive from Medicaid in order to deliver Medicaid benefits to enrollees
What is Capitation?
Used to load request for medically needy services
What is TRUCARE?
I must be submitted in original form (red&white)
What is CMS 1500 claim form?
Member's ID number can be found in this box
What is 1A?
The information in this boxes are used for Other Insurance
What are 9a-d?