Where can you view a member’s other insurance in MediTrac?
Mappings- Coordination of Benefits- External COB and Internal COB tabs.
For claim # 0052935161, what are the Adjustment Reason Notes?
Dual LDP coverage, processed primary
Where can you add note to an account in Meditrac?
Events
How is one way you can tell how a claim/ pre auth was submitted?
The blue banner on the member's account
This section explains the reason for each service line's success or failure.
Adj Summary
Where can you find all previous dental procedures submitted for the member, including x-rays.
Dental History
How are you able to tell who Grievances should be filed to?
Right click over member's plan, expand the Custom Attributes and search with CTRL-F
Any left side column button bars with blue text mean what?
there is data available to view
What is Key From Image
is a data entry method LIBERTY uses for claim submissions. The information is manually keyed into HSP/MediTrac.
How do we search for a claim if we only have Claim ID?
Click Claim from top Tool Bar-Binoculars- Find Claim- Enter
What shows the different versions and processes of the claim?
Versions
Why was claim 44441577 denied?
Denied - duplicate claim
Where in Meditrac are we to view the claim processing state from Claim View?
Click the Group- Custom Attributes, scroll down until the CL_Processing State field is visible.
To find a copy of the EOB, payment transactions or pre- auths are printed, what tab is that?
Financials / Documents
If there were any documents or attachments added to the claim, where would we find them?
Attachments
What does the Status Bar on the bottom of the Meditrac screen show?
shows the screen status, processing status, claim status, last worked on date, and last adjudication date.
Member does not have member ID, they provided DOB of 07.31.1962. Looking for an unpdate on claim #004716281
Claim denied on 10.12.23 due to COB errors
Using member ID 563914365-03, why was the claim on 10/12/2022 denied?
Exceeded 1 per office per 12 months limitation
If you needed to pull up a member's account while speaking to an office, are you able to do that?
Yes
What does Version History show?
allows agents to see different versions of the claim, which helps to understand the life of the claim.
Why was Brandon Aaron's estimate (Phone # 3237521614) denied?
Did not meet medical necessity.
If a provider sends in a claim using EDI, what is the time frame for process?
30 days to process.
What are MM codes?
MM codes are used to address clinically denied or pended treatment due to lack of medical necessity.
What can you find in the Results tab?
provides adjudication details for each service line, including payment amounts, explanations, denial actions and more.