Chapter VII: Online Reports View Submenu (04)
About the 050 Claims Returned to Provider
Description
This is a listing by provider of claims in RTP status. The claims on the report are in status/location TB9997. The daily report will be available online for five days.
Report Purpose
To provide a listing of claims that are being RTP for correction. This report will be used by providers to identify the reason code(s) for the returned claims.
The right view of this screen can be accessed by using the <PF11/F11> key on your keyboard. Note the vertical line indicating where the screen has been split.
Use the <PF6/F6> key to scroll down to view the rest of the reason code narrative and/or to access the next claim in the report. At the end of the report, a total of RTP claims and Total Charges are listed.
Use the <PF11/F11> key to view the right view of this screen.
The following chart describes the various fields/report headings contained within the Claims Returned to Provider 050 report.
| Field/Report | Description |
|---|---|
| REPORT | Identifies the report number (050) |
| FREQUENCY | Identifies the report frequency (D = daily, W = weekly) |
| SCROLL | Identifies the direction where more information can be accessed using the <PF10/F10> and <PF11/F11> keys (L = left, R = right) |
| KEY | Identifies the provider number, can be overkeyed to display other provider information |
| PAGE | Identifies the report page |
| SEARCH | Function not used at this time |
| REPORT | Identifies the report number (050) |
| SUBMITTER | Internal user ID |
| CYCLE DATE | Date of report |
| PROVIDER | Provider number – Displays the identification number of the institution who rendered services to a particular beneficiary/patient, assigned by Medicare (13-position alphanumeric field) |
| NPI | National Provider Identifier |
| FOR CYCLE DATE | Date of report |
| FREQUENCY | Frequency of report |
| RUN TIME | Time report was generated |
| FOR PROVIDER | Provider's name and address. This information is taken form the provider file. This field contains four lines and each line consists of 31 alphanumeric positions. |
| MID/CERT/SSNO | Medicare Identification number – Identifies the Medicare idenfication number submitted by the provider for the beneficiary (twelve-position alphanumeric field) |
| PCN/DCN | Patient/Document control number – Displays the identification number for a claim (23-position alphanumeric field) |
| TYPE BILL | Type of bill – Identifies the type of facility, bill classification, and frequency of the claim in a particular period of care (3-position alphanumeric field) |
| PROVIDER/NPI | Provider number – Displays the identification number of the facility listed on the claim (13-position alphanumeric field); NPI – National Provider Identifier |
| NAME | Beneficiary name – Lists the last and first name as submitted by the provider of the patient who received the services (31-position alphanumeric field) |
| ADMIT | Admit date – Identifies the date the beneficiary was admitted for inpatient services or the beginning of the outpatient, home health, or hospice services (six-position alphanumeric field in MMDDYY format) |
| COV FM | Covered from date – Identifies the beginning date of services rendered to the beneficiary as indicated on the claim (six position-alphanumeric field in MMDDYY format) |
| COV TO | Covered to date – Identifies the last date of services rendered to the beneficiary as indicated on the claim (six-position alphanumeric field in MMDDYY format) |
| TOTAL CHGS | Total charges – Identifies the total charges as submitted by the provider (nine-digit field in 9,999,999.99 format) |
| NO TITLE | Reason code – Identifies the reason code(s) assigned to the returned claim (five-position alphanumeric field) |
| NO TITLE | Reason code narrative – Identifies the reason code(s) narrative for the returned claim (77-position alphanumeric field with a maximum of 150 occurrences for each reason code/narrative) |
| TOTAL RETURNED CLAIMS | On last page of report – This is the total number of reported RTP claims (seven-digit field in 9,999,999 format) |
| TOTAL RETURNED CHARGES | On last page of report – This is the total amount of charges for reported RTP claims (11-digit field in 999,999,999.99 format) |
Revised 1/4/2019