Notes

NOTES 01/05
PART 1

Caller's Name:carrie
Callback #:612-262-5574
UMID:h41063345
TAX ID:363261413
Reference #:823051430910

Issue/Concern: Caller is calling about Claim status.

DOS: 10/22/2014
Charge Amt: $41.90
Claim #:038670431

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim paid but went to the provider's write off// checked cis pro but no allowed amt// checked cis TOB 131 RM APC// send back for review// TAT: 30-45 b.days//

Were G and A rights given? No.
01- prov disputing about payment went to prov write- off
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Caller's Name:carrie
Callback #:612-262-5574
UMID:h41063345
TAX ID:363261413
Reference #:823051430910

Issue/Concern: Caller is calling about Claim status.

DOS: 10/30/2014
Charge Amt: $41.90
Claim #:038670423

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim paid but went to the provider's write off// checked cis pro but no allowed amt// checked cis TOB 131 RM APC// send back for review// TAT: 30-45 b.days//

Were G and A rights given? No.
02
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Caller's Name:carrie
Callback #:612-262-5574
UMID:h41063345
TAX ID:363261413
Reference #:823051430910

Issue/Concern: Caller is calling about Claim status.

DOS: 09/16/2014
Charge Amt: $41.90
Claim #:025503008

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim paid but went to the provider's write off// checked cis pro but no allowed amt// checked cis TOB 131 RM APC// send back for review// TAT: 30-45 b.days//

Were G and A rights given? No.
03
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Caller's Name:anne
Callback #:608-280-4441
UMID:H49624490
TAX ID:391128616
Reference #:529334192310

Issue/Concern: Caller is calling about Claim status.

DOS: 07/30/2014 - 08/03/2014
Charge Amt: $932.00
Claim #:997668054
appeal- 11/26/2014 - 383897212019
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim was denied duplicate// prov sent an appeal on 11/26/2014 and we received it last 10/01/2014// inquiry was closed but with no determination// TAT: 30-45 b.days//

Were G and A rights given? No.
04
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Caller's Name:mary
Callback #:480-468-5635
UMID:H44256188
TAX ID:840826336
Reference #:074947283410

Issue/Concern: Caller is calling about Claim status.

DOS: 07/11/2014
Charge Amt: $4022.20
Claim #:985067273
appeal- 11/18/2014
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// appeal received last 11/27/2014// denial was maintained//70553 denied for 0DC// Claim is on FR status on 01/02/2015//

Were G and A rights given? No.

05
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Caller's Name:leslie
Callback #:502-588-0538
UMID:102954705
TAX ID:000030077

Issue/Concern: Caller is calling about Claim status.

DOS: 08/04/2014
Charge Amt: $300.00

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// OOS and transferred to dedicated team: 877-597-7474

Were G and A rights given? No.
06
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Caller's Name:pam
Callback #:218-844-7132
UMID:h53350554
TAX ID:410711588
Reference #:855978085310

Issue/Concern: Caller is calling about Claim status.

DOS: 11/15/2014
Charge Amt: $629.80
Claim #:046398815
auth #: 069117479
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim denied for 08A// Medicare is primary// get in contact with member and call member services to update COB//

Were G and A rights given? No.
07
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Caller's Name:MARK
Callback #:855-457-1309 ext 650
UMID:101766625
TAX ID:582234927
Reference #:094927390211

Issue/Concern: Caller is calling about Claim status.

DOS: 07/15/2014
Charge Amt: $215.00
Claim #:201407151295750
medical records- 12/03/2014
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// medical records not recieved//

Were G and A rights given? No.
08
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Caller's Name:roxanne
Callback #:407-933-1423 ext 221
UMID:h47562715
TAX ID:592180685
Reference #:979051350811

Issue/Concern: Caller is calling about Claim status.

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: logged elig//

Were G and A rights given? No.
09
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Caller's Name:sharon
Callback #:888-671-6558
UMID:H59494690
TAX ID:593123992
Reference #:151892051311

Issue/Concern: Caller is calling about Claim status.

DOS: 07/15/2014
Charge Amt: $784.50
Claim #:984106963

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim denied for 08I - THE NUMBER OF SERVICES EXCEEDS THE AMOUNT AUTHORIZED AND ARE NOT COVERED BY THE PLAN.//
auth #: 057853139// called CIT to confirm if auth is valid for DOS//talked with Ricky and said that auth is VALID THRU 07/05/2013- 08/04/2014// send back for review//



Were G and A rights given? No.
10
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Caller's Name:milly
Callback #: 210-757-4677
UMID:h55783133
TAX ID:742871135
Reference #:978723202411

Issue/Concern: Caller is calling about Claim status.
cooreceted claim- 11/25/2014
DOS: 10/16/2014
Charge Amt: $43.00
Claim #:140219197

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//corrected claim received last 11/27/2014 and still in review//

Were G and A rights given? No.
11
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Caller's Name:jun
Callback #:248-569-5303
UMID:H42639516
TAX ID:202493683
Reference #:527342333011

Issue/Concern: Caller is calling about Claim status.

DOS: 10/27/2014
Claim #:050826133

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim is pended and in review//

Were G and A rights given? No.
12
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Caller's Name:jun
Callback #:248-569-5303
UMID: h57232260
TAX ID:202493683
Reference #:527342333011

Issue/Concern: Caller is calling about Claim status.

DOS: 07/09/2014 - 08/06/2014
Charge Amt: $1350.01
Claim #:047534234
corrected claim- 12/29/2014
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//corercted claim received last 12/30/2014 and still in review.

Were G and A rights given? No.
13
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Caller's Name:jun
Callback #:248-569-5303
UMID: h46746740
TAX ID:202493683
Reference #:527342333011

Issue/Concern: Caller is calling about Claim status.

DOS: 10/29/2014
Claim #:050760963
ref #: 262621594310
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//0>R - TREATMENT AUTHORIZATION CODE NEEDED TO PROCESS HOME HEALTH PERSPECTIVE PRICING SYSTEM CLAIMS. THIS INFORMATION HAS BEEN REQUESTED FROM YOUR PROVIDER//

Were G and A rights given? No.
14
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Caller's Name:jun
Callback #:248-569-5303
UMID: h52905064
TAX ID:202493683
Reference #:527342333011

Issue/Concern: Caller is calling about Claim status.

DOS: 07/19/2014 - 09/05/2014
Charge Amt: $2550.01
Claim #:026066480
11/25/2014
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//0>R - TREATMENT AUTHORIZATION CODE NEEDED TO PROCESS HOME HEALTH PERSPECTIVE PRICING SYSTEM CLAIMS. THIS INFORMATION HAS BEEN REQUESTED FROM YOUR PROVIDER// corrected claim received last 11/26/2014//


Were G and A rights given? No.
15