265. CRB11 Sort hardcopy claims, as approved by CHFS, or its designee. Assign unique claim control numbers and batches to claims 266. CRB12 and accompanying documentation. Log claim, scan/image claim, apply a Transaction Control 267. CRB13 Number (TCN), and assign the claim to a batch for processing, within 24 hours of receipt of a paper claim. Pre-screen hardcopy claims before entering into the system, 268. CRB14 and return those not meeting certain criteria (for example, no provider number) to providers; log returned claims daily. Develop and maintain screening instructions for each claim 269. CRB15 type, according to direction provided by the CHFS. Perform data entry functions and appropriate manual prescreening functions prior to entry of claims data into the system. All required fields, per the CHFS, should be completed. Claims missing any key data elements or 270. CRB16 submitted on an inappropriate claim form are to be returned to the provider and logged into a system that allows appropriate auditing. Online inquiry is to be used, as needed, for required address information to return the claim. 271. CRB17 Return claims to providers for predefined reasons. Destroy hard copy claims and reports, according to HIPAA 272. standards and the CHFS specifications. Log tapes and diskettes, upon receipt, and assign batch 273. CRB19 number. a claim into the MEMS for processing within five 274. CRB20 workdays of being logged in (received in mailroom).
265. CRB11 Sort hardcopy claims, as approved by CHFS, or its designee. 266. CRB12 Assign unique claim control numbers and batches to claims and accompanying documentation. 267. CRB13 Log claim, scan/image claim, apply a Transaction Control Number (TCN), and assign the claim to a batch for processing, within 24 hours of receipt of a paper claim. 268. CRB14 Pre-screen hardcopy claims before entering into the system, and return those not meeting certain criteria (for example, no provider number) to providers; log returned claims daily. 269. CRB15 Develop and maintain screening instructions for each claim type, according to direction provided by the CHFS. 270. CRB16 Perform data entry functions and appropriate manual prescreening functions prior to entry of claims data into the system. All required fields, per the CHFS, should be completed. Claims missing any key data elements or submitted on an inappropriate claim form are to be returned to the provider and logged into a system that allows appropriate auditing. Online inquiry is to be used, as needed, for required address information to return the claim. 271. CRB17 Return claims to providers for predefined reasons. 272. Destroy hard copy claims and reports, according to HIPAA standards and the CHFS specifications. 273. CRB19 Log tapes and diskettes, upon receipt, and assign batch number. 274. CRB20 a claim into the MEMS for processing within five workdays of being logged in (received in mailroom).
Attachment_I_-_MEMS_Fiscal_Agent_Requirements[1].docx