Day 1
This field on a CMS-1500 form will indicate if the claim has been corrected.
What is field 22?
This is the location code for Inpatient Hospital.
What is 21?
For claim status a provider would verify this. (6 things)
What is: NPI, Caller's name, Member ID, Member's Name, DOS, and Billed/Claim Amount?
Claim number 200406M01959 was submitted by this method.
What is paper, mailed or manually?
This is the provider's bible for all things BC NC related.
What is the Provider Administrative Manual better known as The Provider Blue Book?
This form is used by hospitals and skilled nursing facilities.
What is UB-04?
Claim number 200309E00240 was received on this date.
What is March 9, 2020?
This designer search shows the total number of claims paid on a check.
What is the CK search?
An INN (Participating) Provider has this long to file a claim.
What is 180 days from the DOS?
Once on the claim summary inquiry screen (IQ1200) you can click here to see the member's PCP.
What is the Service Dtl Inquiry tab?
This type of code always has a decimal as the 3rd digit.
What is a diagnosis (Dx) code?
A status code of 91 indicates the claim was this.
What is mailed back?
To determine where a provider's check was mailed you will reference this screen and address.
What is the ADDR screen and financial address?
A provider will mail a corrected claim to this address.
What is: Experience Health Medicare Advantage (HMO) P.O. Box 17509 Winston-Salem, NC 27116-7509?
Check status 11 means this.
What is outstanding (not cashed)?
This is the bill type for an outpatient hospital original claim.
What is 0131?
The designer search to locate a claim using only the claim number.
What is CS?
To locate a provider's EOP in Mobius you will need to search by this NPI.
What is the billing or group NPI?
An OON (Non-participating) Provider has this long to file a claim.
What is 12 months from the DOS?
To locate the description of a CPT code you can use this designer search.
What is PRS?
A9500 is this type of code.
What is a HCPCS code?
LT, RT and 26 are types of these.
What are modifiers?
Complete claim status for a member consist of these 5 pieces of information.
What is: total billed amount, allowed amount, member responsibility, paid amount, and paid date?
The provider can use this system to verify member's eligibility, benefits and check claim status.
What is Blue E?
You can use this system to locate a claim image.
What is Docrequest?