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What is trigger 35
Timely filing
What are the Codes that you need description for
E1399/ K0108/ B9998
What if the address is missing in HRP
PDM
What is In-Network
Par status
My work icon
file folder
No authorization found
D22
Codes that does not require an EOB/COB
Home Care and DME
What do you do if your claim is over your threshold
route to Senior lead or Lead
What is Out-of-Network
Non-Par
Utilization
clip board
what is needing a referring practitioner
Where to look for a Negotiated rate
Authorization- service set note or agreement details
WHat if the pracititoner role is not found on Xwalk or HRP
PDM
What is the Benefit Network
Medicare and Medicaid
Pin
Comment on audit log note
What is out-of Network
160/ UMD018
What if there is not Authorization found
D22
What if your claim has a EOB
Route to COB
what does a Practitioner need to be In-Network
Credentialing
Claims
Paper
There is no COB or EOB submitted
86/ D11
What 4 things do you need for E1399
Description, Authorization, Negotiated Rate, Manual price
What if the Benenfit Network is missing from Supplier location, supplier, or practitioner
Route to HWPIM
What does not require a referring practitioner
Labs, DME, Office Visits