Pre-Existing
Subrogation
85 pend messages
COB
HPDB
100
6/12/18 is standard for what?
What is the pre-existing exclusion period.
100
This is the standard diagnosis list as of 2009.
What is option 4?
100
This pend message will display when a CPI indicator is present.
What is A-CPI?
100
This the other insurance type for processing a Medicaid Claim.
What is type "G"?
100
This is the section where benefits for a well woman exam can be found.
What is under schedule of benefits sub section routine?
200
These conditions cannot be considered pre-existing.
What is maternity, Newborn; if the child is covered within 30 days of birth, adopted children under the age of 19 if covered with in 30 days of adoption.
200
This option number is entered in BWAA to determine what subrogation list the plan utilizes.
What is 51?
200
This is what a BLX pend message is also refered to as.
What is GJAH?
200
This is my other insurance value when I am over 65 years old and actively working for the ABC company. I also have Medicare.
What is MSE?
200
This is where you go to see if batteries are covered for a power wheelchair.
What is Home Health Care/Skilled Nursing/Hospice Care Benefits/DME?
300
2014
What is the year when pre-existing is no longer applicable.
300
This letter is populated in the AFV field when the CSA must check for possible accident conditions.
What is a "C"?
300
You will receive this pend message when a claim crosses policy years.
What is P-CPP?
300
If UMR updates other insurance this is where it is housed.
What is under General Provisions in the HPDB?
300
This is the section you review to determine what COB provision a customer has.
What is General Provisions?
400
PREXINEE; PREXINQ2; PREXINQ1
What are the pre-existing letters a CSA would send to investigate.
400
This is the dollar threshold utilized when investigating a possible MVA.
What is $500?
400
The OPI EV for Skaggs domestic will pend with this message if units are billed in excess of 99.
What is P-PSS?
400
This is the other insurance value for when you are an employee of Oakdale Police Department and have family coverage through UMR. You are married to Carly and have 2 children together. Your son from a previous marriage is also living with you since his mother passed away. your DOB is 3/20/1972 and Carly's DOB is 3/3/1974. Carly works part-time at a night club with no health benefits.
What is NO?
400
Claim P&P contains all step by step procedures for processing CPS claims.
What is false?
500
Diagnosis 005.1 can be found on this list.
What is the three month pre-existing list?
500
This is the ineligible and release codes utilized when denying a claim for accident details.
What is ineligible 998 with a release code of 71?
500
This edit indicates multiple policy limits have been met.
What is R-POL?
500
This ineligible code is used when Medicare is Primary and the MEOB was not received.
What is 005?
500
This is who you contact when a piece of information is missing or unclear. You can find this information in this system.
What is a customer specialist, who can be located in BWAA under option 41?