eCAMS
This "Claim Type" in eCAMS indicates a HCFA claim form was submitted.
What is a P-Professional claim?
In order to seek Non-Emergent Community Care with the assurance their claims will be paid by the VA, the Veteran must first obtain this.
What is an Authorization? (Pre-authorization)
The JLV widget one may check when an emergency claim is rejected for "...medical records...:.
What are Documents & Images?
Receiving one of these, equals one CRM interaction.
What is a Phone Call?
The specific law that states all Non-Emergent Community Care must be pre-authorized before being seen, in order for the VA to pay on the EOC.
What is Title 38 U.S.C 1703 (1703)?
The revenue code on a UB claim form that indicates services were performed at an ER.
What is Revenue Code 0450?
These "Units of Time" on a claim must fall within an authorization's validity dates for the claim to be paid with that authorization.
What are Dates of Service? (DOS)
The document or widget that indicates what services a Veteran has authorizations to seek community care for?
What are Consultations?
(AKA Consult Encounters)
This can be used instead of the Veterans Social Security Number when trying to locate them in CRM.
What is Birthdate?
The specific law that allows the VA to pay some to most coinsurance, for an Unauthorized Non-Service Connected Emergency EOC.
What is Title 38 U.S.C 1725 (1725: Mill Bill)?
The processing system created in order to streamline, automate, and modernize the processing of community care claims.
What is "eCAMS (Electronic Claims Adjudication Management System)"?
What is the "PA tab"?
We use JLV to confirm if the patient has what, for a Non-Service Connected Emergency Claim.
What is Other Health Insurance (OHI)?
The request action that can be used in CRM when a claim has an error and needs to be fixed.
What is a Claims Reprocessing request?
If the Veteran wants their ER visit to be considered pre-authorized they or someone on their behalf better call the VA in this time frame?
What is 72 hours?
eCAMS claim status meaning the claim is being processed.
What is Suspended?
This identifier found on an authorization indicates which VA the authorization was coordinated with.
What is station number/code?
You may not see what you are looking for in JLV, if you do not adjust these on your widgets.
What is Date Filter (dates)?
The demographic information you would need to ask a Meaningful Relationship.
What is the callers address?
The document a Provider must submit for a non-service connected emergency if a Veteran has other health insurance.
What is an Explanation of Benefits (EOB)/Explanation of Payment (EOP)/Remittance Advice (RA)?
The title of the page that you land on when you open up a claim in eCAMS.
What is claim header detail?
Soft authorizations used to process and potentially pay Emergent EOCs.
What are 1728 and 1725 soft authorizations.
This hyperlink is clicked in JLV when needing to check enrollment status.
What is patient demographics or Veteran's name?
This scenario would prompt an ACR (Adverse Credit Reporting) request.
What is being sent to collections or a Final Notice?
The Five9 action taken when you are assisting on a crisis call and a Lead or Manager has transferred the crisis line responder to you and you are ready to answer the Crisis Line Responder.
What is Parking the call?