Aux Codes in Max Agent
This is the Aux that you start off in when you first log into Max Agent.
What is Unavailable?
This is the timely filing limit after date of service (Medicaid primary) to file a claim.
What is 365 days?
We currently have this issue with DME pricing.
What is claims are paying at 100% for rental and claims are paying at 10% for purchase?
This is how long you should put a provider on a silent hold unless you've set a different expectation.
What is 60 seconds?
This is what you need to do if you see Edit 153 (PCP is solely responsible for service: pay as capitated) on a claim.
What is refer the provider to the MCE?
This is the Aux that you use for whenever you're going through uptraining.
What is Unavailable: Training?
This is the Payor ID for Ohio Medicaid FFS.
What is MMISODJFS?
This is happening with adjudication.
What is claims are stopping during the adjudication process and edits are not firing?
This is the goal for the amount of time it should take to wrap a up a call after speaking with a provider.
What is 60 seconds?
If you see UM Not Found (Edit 606) you should do this in the Pay tab.
What is view the authorization number listed?
This Aux is only used when you're going to a team meeting.
What is Unavailable: Meeting?
This is a type of Medicare that covers member's doctor visits.
What is Medicare Part B?
This is happening with Medicare Crossovers.
What is they are failing to crossover to Medicaid for COB?
This is the percentage goal for quality and can be reached by reviewing your evaluations to ensure that you are focusing on your areas of opportunity.
What is 90.50%?
You should check here on the claim if you see Edit 915 (Claim has been manually denied).
What is the memos/attributes of the claim?
This Aux is used for your 15 minute break.
What is Unavailable: Break?
This is the Ohio Medicaid BIN Number for Pharmacy.
What is 024251?
This is happening with claims from the old MITS system.
What is converted claims from the old MITS system do not contain edit or processing information and never will in VUE360?
This is the goal for AHT (Average Handle time) which is a combination of your talk time, hold time, and wrap time.
What is 600-720 seconds?
If you see edit 6239 on a claim, you should do this.
What is complete a claim escalation to Brandon in VUE360?
You should always use this Aux at the end of your shift.
What is Log Out?
These payments are made on claims that include T codes, G codes, and/or DME codes and are paid via waiver dollars.
What are wraparound payments?
We are seeing this issue with some lines in COB processing.
What is there is a known issue affecting lines being paid as primary?
This is your adherance percentage goal.
What is 93%?
If you see edit 6029 (Future DOS End Date for DME) on a claim, you should look at this first.
What is the date of service on the claim?