Screens
COB
Claims
DMI Screen
CODES
100
MHI Screen
What is the screen we use to view detailed claims info?
100
FALSE
True or False Humana will coordinate Benefits with Tricare/Champus/ChampVA(Active Military Coverage)
100
PAID
when a claim is processed and a check or electronic funds are issued the claim has been ___________
100
DMI,SSN#,First Name,EE,HCPCS Code
What is the command line to the DMI Screen?
100
Craniectomy:with excision of tumor or otherbone lesion of skull
What is CPT code 61500?
200
RFI and RSI Screen.
What are the two screens used to view referral/Authorizations?
200
The Subscriber whose birthday (based on month and day) which occurs earliest int he calendar year is considered to be the primary carrier.
What is the Birthday Rule?
200
Paper claim
What type of claim is mailed to humana and scanned into the system?
200
its used to go from the Detail Screen to the Summary Screen.
What is the F6 button used for?
200
the POT is dispalyed inthe T field
What field is the POT code dispalyed in CAS in the MHI Screen.
300
the MAI Screen.
What is the screen we use to find the accumulations for a member?
300
Tefra and Obra
What are the two Federal Rules that help determine Primary vs. Secondary for Medicare?
300
EOB Explanation of Benefits
Once a claim has been processed what is sent to the member advising them of the claim status?
300
DMI Screen is used for accumulations when giving DME benefits or Reviewing DME Claims.
What is DMI screen used for?
300
P field specifies if claim line was paid pended pr denied.
What does the Payee (P) field specify in the MHI Screen?
400
the ASI Screen allows to perform a search using a full or partial first or last name.
which screen allows you to search for a member/dependent by name when members identification is unknown?..
400
Tefra - tax equity and Fiscal responsability act of 1983 Obra - Omnibus Budget Recognition Act of 1986
What does Obra and Tefra Stand for?
400
to inform the provider of how the claim was processed
What is the purpose for the EOR?
400
Message is displayed if there is NO paid and or processed claim with the HCPCS code in history.
when does the DMI screen display Message RECORD NOT FOUND?
400
HDR modifier can be added to the MHi command line to view DX DX2-DX9
What is the Modifier you can add to the MHI screen command line to view other Diagnosis?
500
True
True or False The MRI Screen contains much of the same info as the ASI Screen, but it provides additional info as well?
500
30 Months
What is length of the coordination or eligibility Period?
500
CMS-1500
If amother takes her child to the doctor for a 6 month check-up which form will be used to submit the claim?
500
DMI Summary Screen.
What is the mentor Doc. for the DMI command line?
500
when searching for a Rev Code we place a 0 infornt of the Code.
when we want to enter a Rev Code in mentor what do we need to do?
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