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The Claim Listing page lists all the claims you have entered for a selected RRE ID and RRE Name.
The claims may be sorted by selecting the title of the column you wish to sort. Selecting the same column again will reverse the sort order for the column.
The list may also be filtered by entering values in the columns you wish to filter. To remove a filter, simply remove the value from the filter row, or select the Clear button. Selecting the Clear button will remove all filters. Multiple fields can be entered to refine your search. A page control at the bottom shows the number of entries per page, as well as the total number of pages and entries available.
Click the Latest DCN entry to go to the Claim Information page for the selected claim. From there you can complete claims that have been saved but not yet submitted or edit claims in other statuses (except Delete).
Click New Claim to go to the Injured Party Information page to enter a new claim.
The following information appears for each claim:
Claim Listing
| Field | Description |
|---|---|
| Latest DCN | This is the document control number assigned by the system to identify a claim. Each time you submit more information about a particular claim this number will be updated. The DCN is also a link to the detailed information about the claim. When clicked, it will take you to the Claim Information page. You can only search on the most recent DCN for a claim. Click the History link under Actions to view prior DCNs for a claim. |
| Trn Cnt | Number of transactions or DCNs associated with this claim. This count represents the number of entries in the history. |
| Policy Number | The insurance policy number entered on the Insurance Information page. Note: To ensure updates are applied to recovery cases appropriately, remember to submit this number uniformly with a consistent format. When sending updates, enter the policy number exactly as it was entered on the original submission, whether blank, zeros, or a full policy number. |
| Claim Number | Claim number assigned by the RRE/insurer |
| Medicare ID | HICN or MBI. This was the current Medicare ID when the claim was first submitted. If the beneficiary's Medicare ID changes before you need to make an update to your claim, you can still update the claim record with the older Medicare ID. The system will automatically link the old and new IDs to process the claim. Note: This is also known as the Medicare Number to CMS’ Medicare beneficiaries. |
| Beneficiary Name | Name matched in the Beneficiary database. |
| CMS Date of Injury | Date of Incident (DOI) associated with the claim. |
| Initial Entry Date | Date that the claim was first entered. If multiple transaction updates have been applied, it is the date of the first transaction. |
| Last Action | Last transaction type processed for the claim. Values are Add, Update, or Delete. |
| Status | Status of the last transaction. Values are Saved Not Submitted, New, In Process, Error, Completed, or Deleted. |
| Disposition | Disposition of the last transaction. Values are: 01 - Record accepted, applied at CWF 02 - Record accepted no ORM reported 03 - Record accepted, but coverage period does not overlap with the injured party’s entitlement period SP - Record received processing errors. See the S111 NGHP User Guide on the CMS website for more information about errors. Note: Processing errors will appear at the top of the Claim Information page. |
| Actions | Two action links are available for the selected claim: History and Delete. |
| History | Click to view a record of the transactions associated with this claim. |
| Delete | Click to delete a claim. When clicked, the Delete Claim? dialog appears. Click Delete to delete the claim or Cancel to cancel the action. This action should only be used if the record was created in error or should not have been submitted. |
September 2024
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