Bill Header Level

The Header Level provides an overview of the bill, and this information is displayed on the Header Details page of the bill. To access a bill’s Header Details page:

  1. From the Inquire Claims page, find the bill you wish to view using the filter fields as described in “Section

  1. From the filtered results, click the hyperlink in the TCN column for the bill you want to view.

The system displays the Header Details page.

The Header Details page provides basic information about the bill that includes:

  • Client ID (who the bill is for)

  • Billing Provider NPI (who billed for the goods or service)

  • Servicing Provider NPI (who provided the goods or service)

  • Status of the bill

  • Dates of service

  • Reimbursed Amount (how much was paid)

  • Warrant/Automated Clearing House (ACH) Number (check or Electronic Funds Transfer [EFT] number)

  • Remittance Advice (RA) Number

  • Errors to resolve (any errors associated with a bill that need resolution)

This Header Details dialog includes additional detail tracking any changes a user has made to the bill in the system. You can view detailed information about the bill directly from the page by selecting any of the blue hyperlinked field labels:

  • Parent TCN – When a claim is adjusted, a new TCN is created and the original TCN is preserved as the parent TCN for the claim. The Parent TCN hyperlink links to the Errors to Resolve/Header Details dialog for the original TCN.

  • Claimant ID – The Claimant ID hyperlink navigates to the client’s Demographic Detail page.

  • Billing Provider NPI, Billing OWCP ID, and Facility NPI – These hyperlinks navigate to the Provider Details page for the specified provider or facility.

  • Primary Auth – This hyperlink navigates to the Authorization page for the specified primary (or prior) authorization.

  • Diagnosis Code – This hyperlink navigates to the Diagnosis Codes page where each diagnosis is listed along with hyperlinks to the Diagnosis Summary page for each diagnosis.

  • Inbound 837 File Name – This hyperlink displays the Download File dialog, which allows you to open or download the available 837 file for the bill.

Note: The field labels are hyperlinked only when data populates the fields.

Table 5‑ shows the icon hyperlinks will appear at the top of the Header Details page if the claim has notes, attachments, or submitted values:

 

Icon

Description

 

The Notepad icon is displayed when there are notes on the claim. Clicking the icon opens the Notes dialog, which lists the notes in the following sections:

Claim Notes

Refer Claim Notes

Resolution Notes

 

The Attachment icon is displayed when there are attachments associated with the claim. Clicking the icon opens the Correspondence Retrieval Page, which provides you with links to the listed correspondence or attachments.

 

The Submitted Values List icon is displayed when there is a list for submitted values on a bill. Clicking the icon opens the Submitted Values List dialog, which shows the TCN, original TCN, and element value.

 

The Change Log icon is displayed when there are change log records associated with the claim. Clicking the icon opens the Change Log page, which shows which data field was changed, the old and new values for the field, the date modified, and the ID of the modifier.

 

Searching for a Bill Searching for a Bill.”