CGS Additional Electronic Options to increase business productivity
There are additional electronic options available which will increase your business’ productivity. These options include Claim Status Inquiry (CSI), payable Certificate of Medical Necessity (CMN) status, 270/271, 276/277, and Electronic Remittance Advice (ERA).
Claim Status Inquiry (CSI)
Claim Status Inquiry (CSI) allows you to electronically check the status of production claims after they have passed front-end editing and received Claim Control Numbers (CCNs). At least three working days after you successfully file an electronic claim, you will be able to locate your claim in the processing cycle. Through CSI you will know if your claim has been paid, denied, or is still pending. If you are checking the status of pending claims, there are additional screens available which contain more detailed status information.
270/271
The HETS 270/271 application allows providers or clearinghouses to submit HIPAA compliant 270 eligibility request files over a secure connection. HETS 270/271 submitters must have a mechanism to send 270 eligibility requests and receive 271 eligibility responses in a real-time environment.
276/277
The Health Care Claim Status Request (276) and Health Care Information Status Notification (277) provides information regarding specified claims.
Electronic Remittance Advice (ERA)
An Electronic Remittance Advice (ERA) is an electronic data file that shows claims that have been paid and the dollar amounts for each. It also shows claims that have been denied and the reason for denial. This document contains the same information as the paper Remittance Advice (RA) suppliers receive through the mail. When the ERA file has been downloaded, it must be run through ERA reader software to allow you to view and print out the document in a readable format. ERA reader software may be purchased from a software vendor.
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