Can you resubmit a denied claim once correct on Web Tool?Yes. Copy the claim, correct it, and submit it. |
Can you resubmit the same claim via the Web Tool?Yes, if you submit a new claim, you will get a new CCN. |
Can you send me a copy of the Remittance Advice (RA)?Copies of Remittance Advice statements can be retrieved online via the Web Tool. If the remittance advice date is not available, complete a Duplicate Remittance Advice Request Form in the Forms Section of all provider manuals. There is a processing fee of $20 plus 20 cents per page copied. The charges will be deducted from a future Remittance Advice, appearing as a debit adjustment. The duplicate RA policy was enacted in December 2010. |
Can you use the Web Tool for adjustments, if you filed through a clearinghouse?Yes, you may submit an adjustment through the Web Tool, even if the original claim was filed using a clearinghouse – as long as it is within 15-18 months. However, UB-04 (Institutional) billers must file adjustments in the same medium as the original claim. |
Do I have to request another Login and Password if more than one person wants to use the Web Tool?Yes, all users must have their own individual login ID and Password to access the Web Tool. If more than one user tries to login under the same login ID and Password, they will receive a denial message. |
Do you have to put in diagnosis codes?If the service you are providing requires the use of a diagnosis code, then you must enter the diagnosis code with your claim information. |
Do you have to put the last 4 digits of the zip code for Claims Entry?Yes; you can find zip codes on the US Postal Services website: www.usps.com. Click on Look Up a Zip Code™ |
Do you have to submit claims through Web Tool?No, you may use other options like hard copy or vendor/clearing house. |
Does Suspended mean processing?No; Suspended means that the claim is in review. |
Does the Web Tool’s Lists feature allow you to save a beneficiary’s prior authorization in a field?No, prior authorization may not be necessary for all services. There is a field for prior authorization. |