Learning Resources
Frequently Asked Questions
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Will the system distinguish that a company has multiple provider numbers?Yes, make sure all their information is correct when completing the claim form. | |
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. | |
What happens if you void the wrong claim?If it is voided, you can submit a new claim in. | |
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. | |
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. | |
Can claims be lost via the Web Tool?Generally, they don’t get lost using the web. | |
If doing a void/replace adjustment, does the Form 130 go along with the CMS-1500 claim form?Yes, the replacement claim will be attached to the Form 130. | |
How are split claims broken up?A 10 in your CCN represents 8 lines; 20 is the next 8 lines, etc. | |
How long does it take to process an adjustment?It takes approximately 30-45 days to process an adjustment - the same as a normal claim in process. | |
Where can carrier codes be located?Carrier Codes can be located in Appendix 2 of the Provider Manual. | |