WGS Pop-Ups
Where could you find the WGS Pop-Ups on your WGS Screen?
What is the lower left corner of the screen.
What are Pop-Ups commonly used for?
They are most commonly used to communicate special processing conditions the claim encountered when going through the adjudication process.
On the EXAMADJ screen, what two digit code do you enter in the Option field to perform a provider search?
What is PA - Provider Data Acccess.
What are WGS edits?
What are the system's way of informing you of an area on the claim that needs your attention.
True or False:
We do not need to delete spaces on a DCN number when searching in WCF?
What is False.
What information does the CB Pop-Up contain?
What is the Coordination of Benefits information.
Fill in the blank.
For inpatient and outpatient claims, additional surgical procedure codes and dates are displayed in the ______ pop up.
What is the I9 pop up.
What number do you enter in the ALT field before you input the NPI number in WGS doing a provider search?
What is 33.
When you see this type of edit, read the error resolution screen and then go on processing the claim. The purpose of this edit is to inform you of what processing rule needs to be followed.
What is an informational edit.
If the DCN has an alpha camera reel, what is added to the DCN?
What is the century year.
Which Pop-up is used to state that a payment goes to a special recipient?
What is SP.
This Pop-Up is identified by the system as possible duplicates.
What is the DP Pop-Up
Provider data can be searched based on what information when coming from a claims window.
What is Organization, individual and HMO data.
What type of code is required to resolve on a WGS hard edit?
What is a Bypass Code.
When you log into WCF, the program opens on the content search page, what is the drop down selection for "Role" and "Search" fields?
What is "Claims Corro" and "Universal Claims Corro"
Name at least 3 reasons that WGS Pop-Ups are used for.
1. Indicate the other carrier's handling of a claim
2. Display pricing if the pricing is from CS90
3. Add text comments to a claim.
4. Display both the revenue and HCPCS/CPT code information when submitted by the provider,
5. Display claim editing information informing you of the results of an audit done on charges billed by the provider and of the appropriate allowance.
How do you access Pop-Ups on your screen?
To access, put your cursor on the Pop-Up code and press the ENTER key on your keyboard
What key should you press to view the provider's contract and network option in WGS.
What is the F10 key.
What are the 3 types of WGS edits?
What are soft edits, hard edits and informational edits.
You use this field when you are searching by the image number.
What is the EDIDCN field.
Fill in the blank.
The MR Pop-Up appears when the claim has been reviewed by _______ ________.
What is Medical Review (PSCCR).
What is the two digit Pop-Up for Medicare?
What is the MC Pop-Up
When searching for a provider by the NPI number, what field would you enter this information in?
What is the ALTKEY field.
True or False:
You can only use one bypass code on a single claim.
What is False. You can use numerous bypass codes on a single claim, but only use if you resolved the edits.
Which two fields are considered key retrieval fields in WCF and are the most common?
What are DCN & EDIDCN