Learning Resources
Frequently Asked Questions
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If you have a multiline claim and only one line needs recouping, you still complete an adjustment?Yes, claims are 100% adjusted, all lines will be replaced. | |
What happens if someone in your office initiates a refund with the 205 and an adjustment, how do you get it back?The program area would have to research the adjustment to return funds. | |
What happens if you void the wrong claim?If it is voided, you can submit a new claim in. | |
Can you submit two claims forms to void/replace a ten-line claim?Yes you can, as long as it is not a duplicate claim or void only; then, refile a 4-line and 6-line claim. | |
Will the system distinguish that a company has multiple provider numbers?Yes, make sure all their information is correct when completing the claim form. | |
Do you file to another payer when you know services are not covered?Yes, this is considered a valid denial. | |
Do you have to ask MIVS to research TPL non-payment?No, they do this on their own to ensure payment. | |
Does the Medicaid card have all the information needed?No, you should further investigate eligibility using eligibility resources and the information provided on the card. | |
If I send a HIIRF, will I see anything saying it was received?No, just wait a few days and check eligibility again. | |
What do you do if monies are sent to the patient?Change them to self pay after or before service completion. | |