Performing PA Inquiries • Explain how to perform an inquiry into PAs using either tracking numbers or query criteria. • Explain how to perform an inquiry into 278 batch auto-rejected PAs using the query criteria.
Modifying Required Information for a Prior Authorization
In this module, you will learn how to modify different details in a PA in the system before it is approved by the State.
Responding to Prior Authorization Requests in Batch
In this module, you will learn how to view code rates and modify the procedure dates on authorized units and amounts in the system.
Approving Mass Resolve Batches
In this module, you will learn how to approve Mass Resolve batch results. You will also learn how to approve a single claim from a batch.
Rejecting a Mass Resolve Batch
In this module, you will learn how to reject a Mass Resolve batch before validation. You will also learn how to reject a Mass Resolve batch post validation.
Maintaining the Account Code Batch Template
In this module, you will learn how to upload and download a rule template, mark an account code batch template as reviewed, and cancel an account code batch file.
Rejecting Mass Adjustment Batch
In this module, you will learn how to reject claims within a batch. You will also learn how to reject the entire batch.
Creating Mass Adjustment Batches Using Excel Upload
In this module, you will learn how to create mass claim adjustment batches, through the Excel upload method.
Reviewing Mass Replacement/Void/Resurrection Results
In this module, you will learn how to view the status of a mass adjustment batch and submit a batch to an approver.
Changing a Batch Before Finalizing Manual Mass Enrollment Changes
In this module, you will learn how to change a batch in PRISM.
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