how to?
in a claim/TAR inquiry screen, what do u type in the next function field to look up an adjudication code?
AC into the next function
a notice of authorization (NOA) can be submitted for re-evaluation? if so, how many times?
only ONCE
what Function how to get to FAME ?
14+10
or 26+2
function for NPI rendering for provider ?
14+7+9
function for provider finacials?
14+12
what does it mean when delimiter code (DC) 10 is shown for a procedure in CD-MMIS?
Procedure was denied
where can providers find detailed instructions on how to complete medical dental forms including claim/TARs, NOAs, and RTDs?
in the provider handbook on the medical dental provider website
what function for History cross check?
14+5
calAIM enrollment function?
14+31
functions for claim index?
14+4
by member ID
in a claim/tar inquiry screen, what does ADJ date mean?
Adjudication date and date claim was processed
how long does a provider have to be complete services allowed on notice of authorization (NOA)?
180 days
function for Claim/TAR inquiry?
14+3
provider billing function?
14+6
what screen do we put NOARP on for a reprint of authorization Letter?
14+4
4= claim/TAR index
what does it mean if in CD-MMIS a claim or TAR shows present DCC: 4A for 3 days ?
the document has been processed 3 days ago
how many days does a provider have to respond to a Resubmission turnaround (RTD)?
45 days
function for billing provider information ? (by biling NPI)
14+6+12
function for service office ?
14+8
if you see an questions mark on any claim/ tar index what does that mean?
its in process still
what does R&S refer to in Claims ADJ?
Replace and substitute
what distinguishes a claim from a treatment authorization Request (TAR)?
Claim has a date of service, a TAR does not
a claim has a rendering provider NPI, a TAR does not
function for Service office details ? (by biling ID)
14+8+1
function for provider summary?
14+11
f4 is used in CD-mmis for?
more information