Timely Filing
The maximum period for medical claim submission.
What is twelve months?
This is a notification to an insurance company that payment of an amount is due.
What is a claim?
This code tells what services were rendered.
What is a CPT code?
This screen contains detailed information for a member.
What is MHI?
Claims are processed this way.
What is in the order they are received?
This is used as the filing date for claims.
What is the postmark date?
The possible outcomes of a claim are.
What is paid, denied, partial denied and pended?
This code identifies diseases, disorders, symptoms and medical signs.
What are diagnosis codes?
This screen allows you to view claims by a specified date range.
What is MDI?
Sent to the member after the claim process.
What is an EOB?
Timely filing rule for hospitals is based off of this.
What is the discharge date?
This displays all claims on file.
What is claims summary?
This code consists of a group of letters which provide the reason the services were rendered.
What are cause codes?
This modifier will provide you with the member responsibility.
What is the L modifier?
This explains why a claim was denied.
What is an Ex (Denial) code?
Timely Filing rule for provider claims is based off of this.
What is the from date?
This is used when all of the information you need to log is captured on one page.
What is log and finish?
The three industry-standard procedure/service codes.
What are CPT, HCPCS and REV codes?
The control line for the MHI screen.
What is MHI,member ID#,,first name,relationship?
This is submitted when a mistake was identified on a previously processed claim.
What is a corrected claim?
Timely filing given to members by CMS to submit a DMR.
What is 36 months?
This is a dynamic field and will only appear below Patient account number if the claim had an auth/referral tied to it.
What is the authorization/referral number?
This is located at the end of CPT and HCPCS codes and provide more precise descriptions of the service.
What are type codes?
The control line to view all claims for a given year.
What is MDI,member ID#,,first name, relationship,00yy (0019)?
Say this instead of Partially Denied.
What is Paid with Adjustments?