Claims Category 1
If CMS 1500 claim form contains a place of treatment code 31, which POT Code will display on MHI SCREEN IN CAS?
8
Which code consists of a single letter followed by four dights and is used on claims to identify supplies and non physician services?
HCPCS
What is the name of the claim form used by physicians or other health care providers for medical service to submit payment for services ?
CMS 1500
Which link would you click if you are unable to locate the claim in crm?
CAS/CAS(OLD)
CAS claim has a EX CODE 04D on MHI screen, which means Bill HCFA Intermediary for hospices services. to verify hospice effective dates, which CAS screen is used to locate eligibility dates?
CWI
The Mhi screen will allow users to view the detail of a claim which MHI control line is correct for accessing the MHI screen?
MHI,99999999,,NAME(OR Intial), ee, 9999999999
What does the Payee code 5 mean?
Paye to the provider(H provider)
MHI
which modifier is used to locate the member responsibility claim calls upskill in CAS?
L
Which CAS MHI field displays dates the claim was received?
RDT
what is the correct control line used to look up a list of claims for a specific date?
MDI,#########,FIRSTNAME,EE,MMYY
In CAS what does payee code R mean?
deny line item to provider
What are the primary processing outcomes of a claim in CAS?
PAID,PENDED, DENIED
Why should you log information to a crm case?
all info provided to a customer must be documented. logging is a quick and easy way to document the information provided without having to type in free text comments.
which code is used to identify room and board services billed on a facility claims?
Revenue
What is the name of the link on CRM Claims Detail Page that opens Humana image view station. It also allows users to view an image of a paper claim that was submitted by provider?
claim image
Which field on the CAS MHI screen identifies the place of treatment in CAS?
T