In this module, you will learn how a State user can view the claims limit list on the current service line of a claim.
Viewing Claims Information by a State User
In this module, you will learn how to view the claim header and service line information of Professional, Institutional, and Dental claims.
Viewing Pharmacy Claims Header Information by a State User
In this module, you will learn how a State user can view the Pharmacy claim header detail.
Viewing Pharmacy Claims Header Information by a Managed Care Organization
In this module, you will learn how a provider can view the Pharmacy claim header detail.
Assessment: Introduction to Claims Inquiry
Assessment
Claims and Encounters Inquiry: An Overview
In this module, you will be introduced to the Claims Inquiry function of the Claims and Encounters subsystem. You will also identify the different Show menu items that you can use to view the various details of the online claims and encounters and the generated and/or paid MCO transactions.
Modifying Dupe Criteria for a Duplicate Claim
In this module, you will learn how to modify dupe criteria for an exact/suspect duplicate claim.
Adding and Updating Domain Criteria for a Claim Type Rule
In this module, you will learn how to add a domain criteria using list. You will also learn how to add a domain criteria using value.
Approving or Rejecting a Claim Type Rule Definition
In this module, you will learn how to approve or reject claim type rule definition. You will also learn how to approve or reject a domain of a rule.