EEC 1
This is the description of the Acronym EEC
What is Electronic Error Correction?
This is the description of the acronym for ODL
What is Online Desk Level?
This Function is used in EEC to Back out of a claim?
What is F3?
This System is used to research claims and benefits, document all calls and is used on a daily basis for responding to members and adding task.
What is Ncompass?
The term that describes when there are two separate MOOP limits for medical and prescription coverage
What is Split MOOP?
This describes why a claim Suspended in a particular location, and why the claim Adjudicated or processed a certain way
What is a Condition Code?
This screen displays a Workflow of what do when an edit hits on the claim
What is the Jump Screen?
This Function displays the patient account # and document # in EEC
What is f17 or shift + F5
This system is used to check the members benefits to find if coinsurance, copay and deductible applies
What is Lotus Notes/NAEGS
Also accepted: CPL
The Service intent used to view the members Coordination of Benefits
What is Manage Other Coverage?
Contains 14 digits and is made up of 6 components
what is the ICN (Internal Control Number)
also accepted: claim number
When viewing suspense edit code descriptions we must make sure the 780-780 has no _______
what is a qualifier?
This is placed over the Condition code (EDIT) to override a singular line.
What is letter O?
This system is used to check SCCF numbers and check the SF RF AND DF screens for out of state claims.
This Application in NASCO allows you finf the description of procedure codes and the valid place of service where they can be performed
What is HURK?
The Application used to correct claims that suspend
What is HEHK?
The description of edit F027
what is PROVIDER OF THIS TYPE/SPECIALTY CANNOT PERFORM THIS TYPE
OF SERVICE BASED ON THE PROVIDER NUMBER ENTERED ONTO THE
CLAIM.
This function is used to accept the claim.
What is F4?
This system is used to check to authorizations of radiology and xray (MRI CAT, PET) procedures
What is Evicore?
______ at the top under condition codes means there's something going on with the overall claim
What is a Red Suspense Code?
This letter is used to clear a claim worksheet out of your review and the description.
What is the letter R for Release?
The description of Edit U302
what is THIS CLAIM AND/OR PROCEDURE IS A POSSIBLE DUPLICATE OF
ANOTHER CLAIM AND/OR CLAIM LINE.
This function selects the specified desk level.
What is F6?
This system is used to check claims with the denial of Letter K
What is Cotiviti?
In regards to Blue Card, this plan establishes and maintains provider networks
What is the Host Plan/Par Plan