Frequently Asked Questions


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Frequently Asked Questions

 

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WEB TOOL: SUBMIT A CLAIM

If you are missing information, will the Web Tool process the claim anyway?

Yes and no; there are basic required fields that are denoted by asterisks, however if you forget modifiers, the Web Tool won’t recognize that.

Entry link: If you are missing information, will the Web Tool process the claim anyway?

If you copy an entire Web Tool batch over, can you choose which claims to submit?

Yes

Entry link: If you copy an entire Web Tool batch over, can you choose which claims to submit?

If you have primary diagnosis codes, do you have to add additional codes?

No, you just need the primary code.

Entry link: If you have primary diagnosis codes, do you have to add additional codes?

If you make an error and you submit the claim on the Web Tool, is there a way to cancel or make a correction that same day?

Once a claim is submitted via the Web Tool, there is no way to cancel or make a correction to the submitted claim that same day.  Once the claim has gone through the payment cycle, you will be able to see if the claim has been rejected, paid, or suspended.  You will then be able to make corrections to the claim before resubmitting as a new claim.

Entry link: If you make an error and you submit the claim on the Web Tool, is there a way to cancel or make a correction that same day?

Is the Web Tool claim ID number automatically entered?

Yes.

Entry link: Is the Web Tool claim ID number automatically entered?

Is there a limit to the number of claims in a Web Tool batch?

There is not a limit to the number of claims in a batch.

Entry link: Is there a limit to the number of claims in a Web Tool batch?

Under the Web Tool's status option, can I check the status of a claim I submit hard copy?

Yes, it doesn’t matter the submission method.

Entry link: Under the Web Tool's status option, can I check the status of a claim I submit hard copy?

What is the payment cycle?

The payment cycle is: Wed-Mon, payments are processed on Tuesday, and payment is received as early as Friday.

Entry link: What is the payment cycle?

What is the Web Tool’s Non-Contractual box?

The Non-Contractual box is to be selected/entered when the provider is not contracted with the beneficiary’s third party payer.

Entry link: What is the Web Tool’s Non-Contractual box?

When a claim is in a denied status, can you do an adjustment?

You must wait for the rejection, and then do a correction. An adjustment can only be made to a paid claim.

Entry link: When a claim is in a denied status, can you do an adjustment?


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