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HIQA and Direct Data Entry. April 15, 2008. CWF. 123456789Z. Carrico. 121212. 123456789Z. Carrico, Susan. Inquiry Reply. Hospice. 123456789R. Home Health. 123456789R. Home Health. 123456789R. Preventive Services. 123456789R. Screening. 123456789R. Smoking Cessation. 123456789R.
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HIQA and Direct Data Entry April 15, 2008
123456789Z Carrico 121212 123456789Z Carrico, Susan Inquiry Reply
Hospice 123456789R
Home Health 123456789R
Home Health 123456789R
Preventive Services 123456789R
Screening 123456789R
Smoking Cessation 123456789R
MSP Information Carrico 123456789R ZEE123456
Claim Count Summary - 56 123456
Claims Inquiry - 12 Key in patient’s HICN for payment history Entire claim history will be displayed or key in from date and to date for specific time periods
Status Locations Thru Claims Summary - 12 P B9997 – Processed Claim P B9996 – OBRAH Hold S B9099 – Claim Submitted to CWF S B9000 – Claim Ready to Submit to CWF S B6001 – ADR S M50XX – Medical Review S B0100 – Initial Submission S B2500 – Resubmission D B9997 – Medically Denied T B9997 – Return to Provider
123456789Z 123456 123456 123456789Z 123456 123456789Z 123456789Z 123456 123456 123456789Z Claims Correction - 03
123456 Mouse, Minnie 123456789A Mouse, Mickey 123456789B Duck, Donald 123456789C LaPew, Peppie 123456789D Einstein, Albert 123456789E Barton, Clara 123456789F 123456789G Doe, Jane Bush, George W. 123456789H Reports – 04 - 201
123456 123456 Mouse, Mickey Duck, Donald LaPew, Peppie Einstein, Albert Barton, Clara Doe, Jane Bush, George W. Reports – 04 - 201 Mouse, Minnie
123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R Reports – 04 - 702
123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R 123456789R Reports – 04 - 702 123456