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Payment Reasons are entered in Payment Distributions and indicate why a payment was denied or a payment amount was different than the expected amount.
Code
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Payment Reason Code. May be the same code reported by HCFA (CMS) on EOBs
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Lookup
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Lookup value assigned
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Name
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Description
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Reason Type
Paid
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Payment Distributions with this reason on them were claims that were paid
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Held
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Payment Distributions with this reason on them were claims that were partially paid
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Denied
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Payment Distributions with this reason on them were claims that were denied
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Send To
Followup Manager
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Payment Distributions with Reason flagged to go to the Followup Manager will be sent to the Followup Manager for resolution.
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Exception Log
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Payment Distributions with Reasons flagged as Exceptions may be printed on the Payment Exception Report.
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Type
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Indicates the HCFA (CMS) Type of Exception. Values include appeals, coverage problems, enrollment problems, etc.
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Library Change Logs
The Change Log button at the bottom of any MedSuite Maintenance File will track the following:
$ Date Changed - The date the change was made to the file.
$ User Name - The name of the user that made the change.
$ Item Changed - The file name of the item that was changed.
$ Old Value - The system value before the change was made.
$ New Value - The system value after the change was made and saved.
NOTE: Items not tracked are description fields such as degrees and titles.
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