- Introduction
- Chapter I - Online System Terminology
- Chapter II - Online Menu Functions Overview
- Chapter III - Navigating the Online System
-
Chapter IV - Inquiries Submenu (01)
- Accessing the Inquiries Submenu
- Beneficiary/CWF (10)
- DRG (Pricer/Grouper) (11)
- Claim Summary (12)
- Revenue Codes (13)
- HCPCS Codes (14)
- DX/Proc Codes ICD-9 (15)
- Adjustment Reason Codes (16)
- Reason Codes (17)
- ZIP Code File (19)
- OSC Repository Inquiry (1A)
- Claim Count Summary (56)
- Home Health Payment Totals (67)
- ANSI Reason Codes (68)
- Invoice Number/DCN Translator (88)
- DX Proc Codes ICD-10 (1B)
- Community Mental Health Centers Services Payment Totals (1C)
- Check History (FI)
- Provider Practice Address Query (1D)
- New HCPCS Screen (1E)
- Opioid Use Disorder (OUD) Demo 99 (1F)
- Chapter V - Claims and Attachments Submenu (02)
- Chapter VI - Claims Correction Submenu (03)
- Chapter VII - Online Reports View Submenu (04)
-
Resources
- Part A Electronic Medicare Secondary and Tertiary Payer Specifications for ANSI Inbound Claim
- Electronic Medicare Secondary Payer Specifications for Inbound Claims
- FISS UB-04 Data Entry Payer Codes
- Common Claim Status/Locations
- FISS Reason Code Overview
- FISS Reason Code/Claim Driver Overview
- Program Function/Escape Key Crosswalk
- How to Adjust a Claim
- FISS Claim Change/Condition Reason Codes
- How to Cancel a Claim
- How to Correct a Return to Provider Claim
- Online System Menu Quick-Reference
Resources
Common Claim Status/Locations
Status/Location | Claim Disposition |
---|---|
P B9996 | Claim waiting the payment floor hold |
P B9997 | Processed claim – finalized location |
P O9998 | Processed claim (offline) – finalized location |
R B9997 | Rejected claim – finalized location |
D B9997 | Denied claim – finalized location |
T B9900 | Daily RTP location– claims cannot be worked when in this location |
T B9997 | Finalized RTP location – claims can be worked when in this location |
S B0100 | Claim is at the beginning of the system – all claims start here |
S B2500 | Claim has been updated by the provider online – awaiting duplicate check |
S B6000 | Claim waiting for ADR to be created |
S B6001 | Claim waiting for ADR response to be returned by the provider |
S B9000 | Non-ESRD claim waiting to go to the CWF – has cleared all FISS edits |
S B9099 | Claim awaiting response from CWF |
Revised 11/28/16