Users will initiate Provider PI case process, and then review and decisions regarding providers based upon varying scenarios.
Tracking and Reviewing Non-Medicare Members
Track members identified within Audit Studio who are eligible, but not enrolled in Medicare with the purpose to communicate this information to DWS.
Reviewing and Submitting Mass Resolve Results
In this module, you will learn how to view the status of a Mass Resolve batch after Job validation. You will also learn how to review the claims associated to the batch and how to submit the batch to the supervisor for approval.
Resolving Review Indicators
In this module, you will learn how to add or modify review indicators from the header and service line of a claim while resolving it.
Reviewing Spinal Manipulation Information
In this module, you will learn how to reveiw spinal manipulation information for a professional claim.
Reviewing Relevant Dates
In this module, you will learn how to modify relevant dates for a professional claim when resolving a claim.
Reviewing Patient Vision Condition Information
In this module, you will learn how to modify and delete patient vision condition information for a professional claim when resolving a claim.
Reviewing Patient Code Lists
In this module, you will learn how to access and review the Patient Code List information while resolving a Professional claim.
Reviewing Ambulance Information
In this module, you will learn how to review the ambulance information for a claim.