This run screen allows you to verify a member's coverage history in Amisys.
What is IQ0800?
The entity used by providers for EFT and ACH payment information.
What is PaySpan?
This system houses all appeals information.
What is CenPas?
The acronym COB represents this.
What is Coordination of Benefits?
This claim form is used for facility billing.
What is the UB-04?
Centene's main system used for documenting 100% of call incoming calls.
What is OMNI?
This run screen allows you to see if a provider is participating.
What is PR0004?
The name of the template created as a communication tool when requesting help from the Claims Liaisons team through the Claims Inquiry task in OMNI.
What is the ASK Template?
The universal code for Medicaid in Portico.
What is MD?
The system Centene uses for the adjudication of claims.
What is Amisys?
This type of code is only billed on the UB-04 claim form.
What is a revenue code?
When a service line has been split between a negative balance and a payout, between two different payouts, or between a pre-payment and a payout.
What is a split payment?
This system allows you to view images of rejected claims.
What is File Net?
This type of claim cannot be submitted as a corrected claim, it must be sent as an original claim for processing.
What is a rejected claim?
This system serves as the source of truth for prior authorizations.
What is TruCare Cloud?
This Amisys run screen allows you to view claims by member.
What is IQ1300?
This system is known as the source of truth for determining provider status.
What is Portico?
EX code 18 represents this type of denial.
What is duplicate claim service?
The screen in OMNI that allows you to see all the provider's information.
What is the Provider Composite screen?
This can be accessed from the computer desktop or CNET and houses all system applications such as Portico, Amisys, and FileNet.
What is Centene Connect?
The process for handling AI calls.
Once the caller is verified as not being a live human being, or is verified as being an automated caller, advise that Coordinated Care Health Plan does not accept AI calls and release the line.
The number of steps in the claims adjudication process.
What is 6?
A provider checking to see if a member has had a certain procedure code billed can be referred to as this.
What is accumulation?
This run screen to allows you to verify the amount of EFT/check, if cashed, and where it was mailed to.
What is FS0400?
This run screen allows you to view detailed claims information.
What is IQ1200?