POPUPS
Which popup has additional diagnosis codes upto 25
HP
When we find changes in provider name , is it a duplicate ?
yes
provider submitted corrected claim with bill type 7 , but no changes , what is the correct wf ?
respond back stating no changes found in claim , but once chk claim form
under which tab do we get the documents mlh # of a claim ?
attachments
Navigation to standalone
shift f3--f9--f4--enter--enter
Which popup has information on diag codes in a facility claim
I9 popup
When we hv changes in DOS in an INpatient claim ,is it a dup ?
No , its not a dup
Abbreviate CCCR
CLINICAL CLAIMS AND CODING REVIEW
under which tab do we get check related details in ciw ?
payment information
what does YN & NN mean in provider network
In network & Out of network
Claim allowed amount is $250.00 . Claim is paid with $175.00 & $75.00 is taken towards copay . Billed amount is $300.00 . Is the claim PAID correctly ?
Yes
Abbreviate PPRU
PROVIDER PREPAY REVIEW UNIT
Under which tab do we get par/non par status of the provider ?
under claim header tab
Which edit indicates HIT services ?
ACM
Which are all the popups related to clinical denial
CX,IH,TM
For benefits , HOME plan uses which platform to determine the benefits ?
FOBS
What are the 3 conditions on clinical denials
100 c 100 p 000 d
Under which tab do we update comments ?
notes
Which edit triggers when claim bill type is 7
PAJ
Under which popup do we get provider npi's and Stopdata
DS
Bill type 137 means ?
Provider submitted corrected claim , we should adjust original claim
name the 2 decisions the cccr will provider
upheld & overturn
which tab provides us with sf df rf information ?
b2 data
What is lpp date ? if claim is priced incorrectly , the lpp date used while adjusting is ?