Definitions
The place where the services will be provided.
What is Place of Service?
On this page in EZCAP you will find the Auth Action Date, Auth Action Time, and Auth Expiration.
What is the Authorization Pg1?
Continued service, they do not go back to an acute setting.
What is No Break in Service?
In EZCAP you can review the history of the case also referred to the case trail here.
What is Auth Status History (select More if needed)?
HIPAA
What is Health Insurance Portability and Accountability Act?
The provider that performed the service.
What is the Rendering Provider (Servicing Provider)?
On this page in EZCAP you will find the Member's Address and Phone Number.
What is the Member Contact Pg2
Facility where the patient is living and receiving care.
What is SIP (Skilled in Place)?
This field identifies if the case is Post Acute, SIP, HS, or more.
What is the Request Category field?
MOC
What is Model of Care?
Doctor and other health care providers' services and outpatient care, Outpatient, DME, Ambulance
What is Medicare Part B (Part B)?
On this page in EZCAP you will find the Medicare ID # and Authorized Person (if one exists).
What is UDFs Pg3?
Clinical has been requested. UM Nurse will follow guidelines on requesting clinical daily.
What is Waiting on Additional Documents?
Selecting this icon allows you to edit an authorization.
What is Edit Record button (AA)?
HICN
What is Health Insurance Claim Number?
Deemed medically necessary and the authorization has been okayed.
What is Approved?
You go here to get more details about the Auth Request (case).
What is Notes section?
Status used by system to indicate a problem with the authorization.
What is System Hold?
You can find the member's marital status on this page.
What is Member Info. Pg1?
MBI
What is Medicare Beneficiary Identifier?
Facilities that specialize in the treatment of patients with serious medical conditions that require care on an ongoing basis but no longer require intensive care or extensive diagnostic procedures.
What is LTACH (Long Term Acute Care Hospital)?
This field is only used when the Auth Request is for a DME Rental or Purchase.
What is Service Type?
Utilization Management determination conducted during the member’s hospital stay or course of treatment.
What is a Concurrent Review (also called Continued Stay Review)?
If you select this hyperlink it will take you to the provider's information.
What is PCP/AuthID (or PCP ID)?
URAC
What is Utilization Review Accreditation Commision?