LETTERS
WHAT IS THE NAME OF THE RESOLUTION LETTER FOR COMPLAINTS?
PV0113 - OHMCD RESOLUTION LTR -- Letter used for Ohio Medicaid plans to advise of determination of claim review determined to be "complaints"
CAN YOU SAVE DOCUMENTS IN MENTOR? IF SO, HOW?
YES - OPEN MENTOR DOC, IN RIGHT HAND CORNER HIT "I WANT TO" HIT SAVE TO FAVORITES, PICK WHICH FOLDER, HIT SAVE
FOR OH MCD, WHO SENDS OUT ACK LETTERS?
TRIAGE
WHAT DOES A "R" IN THE P FIELD MEAN
DENIED CLAIM
CGX
WHAT IS THE NAME OF THE STATUS LETTERS?
PV0113 OHMCD STATUS LTR - Letter used for Ohio Medicaid plans to advise of status of claim review for disputes determined to be "complaints," A status letter must be sent to the provider every 5 business days until resolution.
WHICH MENTOR WOULD YOU USE FOR PREPAY DENIALS?
PrePay Disputes.
WHERE DO YOU PUT YOUR FINAL NOTES BEFORE CLOSING CASE?
DISPUTE REQUEST REASON & CASE NOTES
IF THERE IS A "FR-Y" HOW DO YOU ACCESS THE FR SCREEN
SHIFT F2
WHAT SITE CAN YOU LOOK AT FOR ALLOWABLES?
CISPRO OR CIS
WHAT IS THE NAME OF THE ACKNOWLEDGEMENT LETTERS? AND DO YOU SEND THESE?
PV0113 OHMCD ACKNOWLEDGEMENT LTR - Letter used to acknowledge receipt of Ohio Medicaid disputes determined to be "complaints" (TRIAGE SENDS OH MCD ACK LETTERS)
WHICH MENTOR WOULD YOU USE FOR "FR" ISSUES?
PPI Recoupment Disputes
WHEN DOING AN EXTERNAL TRANSFER WHERE IN MHK WOULD YOU FIND THE CRM# ?
EXTERNAL TRANSFER STATUS - TAB AT BOTTOM OF MHK
WHAT DOES A "5" or "2" MEAN IN THE P FIELD
PAID CLAIM
IF YOU HAVE A 1/1 ON MHK WHAT DOES THAT MEAN?
YOU RECIEVED A TASK BACK, GO INTO THAT CASE AND LOOK AT THE RESPONSE BACK.
WHERE DO YOU ACCESS SENDING LETTERS?
MHK - BLUE BANNER - RIGHT CLICK - COMMUNICATION
WHAT IS THE MENTOR YOU SHOULD BE LOOKING AT FOR DENIALS
CAS Claim Denial Research
IF THERE IS A DUPLICATE CASE FOUND ON MBR360, WHERE WOULD YOU LINK THAT CASE?
"LINKS" AT THE BOTTOM OF MHK
WHAT DOES LOB 93 MEAN
MEDICAID
WHAT CAN YOU USE TO PREFILL YOUR CLAIM IN CAS?
DIG TOOL BAR
WHERE DO YOU CHECK TO ENSURE YOUR LETTER SENT SUCCESSFULLY IN MHK?
COMMUNICATION TAB AT THE BOTTOM OF MHK
IF YOU HAVE AN AUTHORIZATION DENIAL, WHICH MENTOR WILL YOU USE?
Initial Research of Authorization Disputes
IF YOU NEED TO SEND YOUR CASE TO CRR - DO YOU CHANGE YOUR STATUS SECTION IN MHK?
NO - YOU WILL JUST CHANGE YOUR PRODUCT AND REQUEST TYPE "CRR DISPUTE" AND THEN ADD YOUR NOTES - CASE NOTES NEED TO BE UNDER " PD TEMPLATE FOR CRR ADJUSTMENT " AND THEN HIT SAVE AND SUBMIT
WHAT MODIFIER CAN YOU USE TO ACCESS WHAT CIS# THE CLAIM HAS
CIS
WHEN IT SAYS, "CLAIMS IMAGE" WHERE SHOULD YOU BE LOOKING?
EHUB