ONEVIEW CLAIM INTERPRETATION
What are all the internal codes that can be found on a claim?
TLC Codes
System Flags
RNC CODES
TYP Codes
Disposition Code
Using claim #4682101198358/9, how many times was the claim processed and what's the last processed date?
2 and 03/20/2021
What hot key would you press in Corkboard to load the original claim from ViPr Inquiry?
F2
In iview what can you use to provide you with the date of the image ?
Julian Calendar
using claim #4682130197581/9 what is the rnc on the claim and meaning
1200 HealthCare Professional: Do not bill the patient for the MultiPlan discount through MultiPlan. Please call 866.233.0121 for network information.
Next Steps:Follow the ECP Call guidelines
What is the hot key that can locate the schedule in vipr?
PPO
What is the description for reason not covered (RNC) code 761?
Charges for treatment of ACUPUNCTURE services are not covered under your plan.
What does AP stand for under Correspondence in iview?
Appeal
What is the tlc on claim #4682130698862 /9 and what does it stand for?
NEL- Non-surgical, Emergency, Illness
Is claim 4682101198358/9 prepaid tied?
Yes
In XNET, what is the global index group name we use to look up a Claim Key?
GIX03
What are the two types of claim form?
Who can view a Rnc code on a claim?
Advocate, Processors, customers and providers
What action code would you see to view additional diagnosis codes?
ADC
What are the three documents that can be pulled from xnet
claim, eob,ddar
How can you know if the account has a second level of appeal?
Alerts in Oneview and Resolution letter
Using claim # 4682101198358/9 why was the claim denied?
0041
We have requested additional information on these charges without response. If the information is submitted, we will reconsider this claim.
Next Steps:The CSA should check in iView for the submitted notes/records.
Using the claim 9431708994220-5, What network ID did this process against?
FL305
Using claim #9682106800938/3 provide the appeal mailing address the provider should submit the appeal to.
730 COOL SPRINGS BLVD, STE 800, FRANKLIN, TN 37067.
What is the timeframe after an appeal can be escalated to NAO via email?
75days