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CSSC Operations
/ Medicare Medicaid Plans /
FAQs
/ If rejecting a single encounter for a...
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CSSC Operations
/ Medicare Medicaid Plans /
FAQs
If rejecting a single encounter for a single subscriber, would all loops/segments pertaining to the Medicaid encounter be rejected and therefore deleted from the file being sent to the State, starting with the billing provider HL and up to the next HL (next subscriber or billing provider)?
Medicare Medicaid Plans
If rejecting a single encounter for a single subscriber, would all loops/segments pertaining to the Medicaid encounter be rejected and therefore deleted from the file being sent to the State, starting with the billing provider HL and up to the next HL (next subscriber or billing provider)?
Syntactical edits are applied based on the TR3. A list of edits can be found in the CMS edit spreadsheets on the CMS web site. The spreadsheets can be sorted by 999R, 999E and 277T to identify the edits that may be applied.