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Complete Next Words - Definition of a bill

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Complete the next words - OneBacon

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Complete Next Words - Definition of a bill

Complete the next words - OneBacon

Denisse Mercado
1

31 DOB MATCH FOUND 33 33 32 CLAIM SERVICE CHARGES LINE $0 NO 00 1 31 MULTIPLE DOL 2 DOL DOL PER

Definition of a Bill
CMS : Without a Rendering Address . A page for a Claim # , Claimant name , billed by the same Ptovider ( TIN , Boxes and ) and Zip of Service ( Box ) and the same invoice date . Only consider box by itself as a definition of bill multiple providers are in box .

UB : Without a Rendering Address . A page or series of pages for a Claim number , Claimant name , billed by the same Provider ( TIN , Box ) , Zip of service ( Box ) and the same invoice date .

Amount Charged :
If missing on all service lines : Annotate the send back reason and Route the image to the appropriate send back queue
If missing on some service lines , process bill using . for those lines .
If there are multiple amounts for a service line and there is no clear indication of the charge to use , Route to the appropriate Send Back queue - Keywords -
If there are both handwritten and preprinted charges are present and use handwritten charges .


Claimant Match :
If Claim # not present on image search by Last Name , First Name , + / - 5 days If only one claim record exists in the eligibility file / DP : Select the record If the Claimant Name is not an exact match or is not a close match and the DOL does not match within + / - 5 days Reject as
" If multiple claimant records exist in the eligibility file / DP If one is a match within + / - 5 days : Select the record . If multiple same records are present , compare the .