Claim Forms
The claim form submitted by professional providers.
What is CMS 1500 (HCFA 1500)?
The shortcut keyword for professional claims.
What is PSCLM?
The field that indicates where the service was rendered.
What is place of service?
The field that indicates the date the claim was finalized.
What is the post date?
The source code field indicates what.
What is the type of caller?
The claim for submitted by facility providers.
What is UB04 (UB92)?
The shortcut keyword for Institutional Claims.
What is INCLM?
The field that indicate whether the claim was submitted either electronically or paper.
What is claim indicator?
The field that indicates the amount FEP paid on a line.
What is the net amount?
Code 71 should always show in this field.
What is LOB (line of business)?
The claim form submitted by dental providers.
What is ADA claim form?
This key accesses the shortcut menu.
What is F3?
The information that is located in the DIN/Sender field.
What is the image number or sender code?
The field that indicates the contracted fee schedule amount for preferred providers.
What is the allowed amount?
The 13 digit code to identify your inquiry.
What is an ICN?
The Health Benefits claim form is submitted by whom.
What is the member?
DSHFN accesses this screen in Diamond.
What is Financial Dashboard?
This field indicates an N when services are payable to the provider.
What is pay sub (pay to the subscriber)?
BSNC, one of many denial codes, will show in this field.
What is not cov(ered) reason?
The character limit for the remarks section of your ICN.
What is 750?
ADA stands for.
What is the American Dental Association?
The shortcut PLSVC accesses this screen in Diamond.
What is Place of Service?
This field indicates the pay to identification number.
What is vendor?
The amount that shows in the COB ADJ AMT field indicates this.
What is the primary insurance payment?
The cause code used to indicate a benefits call.
What is 0101?