Manually entered to hold a claim to request other insurance details
What is OF?
100
this is the letter we send when asking for other insurance.
What is OI1?
100
This application pulls eligibility, claim history, call history, accumulators and correspondence history from PowerSTEPP.
What is Family Files?
100
Where Powerstepp lists claim history
What is CL1081?
100
The code that indicates whether a claim is PPO or not
What is capacity code?
200
System generated code to warn the user that pre-existing may apply
What is 31?
200
This is the letter we send to a provider when doing a prex investigatin.
What is PP1?
200
This tab displays the hire date, effective dates of coverage, the riders, tiers, and member notes in Family Files.
What is Eligibility Info?
200
Pop up window where COB allowed and paid amounts are entered
What is F14?
200
The product type used for dental claims
What is D?
300
This hold code denies the service as an excluded item.
What is BE?
300
Letter sent to the member requesting accident details
What is AC7?
300
This Family Files tab displays all the letters that were sent on claims, and indicates if a response was received.
What is Correspondence History?
300
All claims are adjudicated and completed on this screen
What is CL1034?
300
The party that billed the claim and will received the payment
What is the vendor?
400
This hold code is attached to a service code that requires a medical necessity review
What is RD?
400
The pre-existing condition letter sent to the member
What is PI1?
400
When reviewing claim details in this section of Family Files, you can hover the mouse over codes such as benefit codes, service codes, diagnosis codes, and others to get a brief description.
What is Claim History?
400
Precertifications and other authorizations are located here
What is CL1011?
400
The field where the hold code is added on a claim entry screen to apply to the entire claim
What is Hd?
500
This system generated hold code warns you to verify private room necessity
What is PR?
500
This is the field on the CL1034 where you enter the letter code.
What is Ltr?
500
This small button in the upper right corner of Family Files creates a blank call log.
What is telephone (or new call documentation)?
500
Where notes are entered for a member
What is ME1083?
500
This code, used on the Repricing window, indicates which network repriced the claim