Main Review
SME Question
Pend Reason
Attachment
Review/Response Notes
Activity Details
Claim Detail
Audit
Claim Type
Claim Form
Error Level
Business Error
System Issue
No Error
Error Type
Financial Error
Procedural Error
Payment Error
Overpaid
Underpaid
Show Adjustment
Business Team
-- Select BusinessTeam --
Alphonso Molyneux Team
Alta Auker Team
Anjanette Thill Team
Arden Kniffin Team
Candice Cowens Team
Chad Litvin Team
Christian Ortz Team
Clifton Cheves Team
Cristie Hatt Team
Cyrus Amster Team
Deb Ralbovsky Team
Dennise Tircuit Team
Dorris Constantine Team
Dorthey Carstarphen Team
Elenora Schlick Team
Elizabet Bogren Team
Elvina Hinkel Team
Ema Millstead Team
Felicidad Moresi Team
Francisco Berget Team
Galina Zaidel Team
Genesis Sarafian Team
Genevive Caldeira Team
Gertude Halbur Team
Gianna Heppert Team
Golda Durbin Team
Gregory Iriarte Team
Hyun Monaghan Team
Janay Raciti Team
Jodee Mantell Team
Jon Tisdell Team
Jonas Ikemire Team
Karole Chaney Team
Karri Felila Team
Katharine Sayles Team
Kris Arneecher Team
Linda Spadard Team
Louis Daughtry Team
Louise Lebrun Team
Luvenia Limbaugh Team
Mable Pecinousky Team
Mae Georgopoulos Team
Maryrose Blovin Team
Michelle Rideaux Team
Myrna Sulouff Team
Nell Winterstein Team
Olga Warmath Team
Paola Carmickle Team
Phil Manaois Team
Ressie Damrell Team
Reva Parlin Team
Romeo Balasubramani Team
Rozella Dokovic Team
Samual Gabard Team
Sandi Merida Team
Selma Swink Team
Sharyl Sprenger Team
Shawnta Eldreth Team
Sherrill Werkmeister Team
Shona Hanneman Team
Simon Lafemina Team
Stacey Balon Team
Tam Filhiol Team
Tammara Krebel Team
Terrie Hessenthaler Team
Theo Kast Team
Una Gangemi Team
Van Moquin Team
Velma Bolebruch Team
Walker Burkin Team
Yong Mandigo Team
Yvone Alpaugh Team
Search
SOP Referenced
-- Select SOPTitle --
Complex Claim Review Processing
CPT Code Equivalent Processing
Dental Services Processing
Emergency Service Processing
Medical Reimbursement PPN Processing
Newborn Processing
Precertification Processing
Referral Guideline
Search
Error Category
-- Select ErrorCategory --
Appeal
Authorization
Benefit
Benefit Implementation
Communication
Compliance
Cost Containment
Dental
Documentation
Duplicate Payment
EDI
Eligibility
Other Insurance
Pharmacy
Proficency
Provider
Reimbursement
Timeline
Error Code
-- Select ErrorCode --
Appeal - 001
Appeal - 002
Appeal - 003
Appeal - 004
Appeal - 005
Appeal - 006
Appeal - 007
Appeal - 008
Appeal - 009
Appeal - 010
Authorization - 001
Authorization - 002
Authorization - 003
Authorization - 004
Authorization - 005
Authorization - 006
Authorization - 007
Benefit - 001
Benefit - 002
Benefit - 003
Benefit Implementation - 001
Benefit Implementation - 002
Benefit Implementation - 003
Communication - 001
Communication - 002
Communication - 003
Communication - 004
Communication - 005
Compliance - 001
Compliance - 002
Compliance - 003
Compliance - 004
Compliance - 005
Compliance - 006
Cost Containment - 001
Cost Containment - 002
Cost Containment - 003
Cost Containment - 004
Cost Containment - 005
Cost Containment - 006
Cost Containment - 007
Cost Containment - 008
Cost Containment - 009
Cost Containment - 010
Cost Containment - 011
Dental - 001
Dental - 002
Dental - 003
Dental - 004
Dental - 005
Dental - 006
Documentation - 001
Documentation - 002
Documentation - 003
Documentation - 004
Documentation - 005
Documentation - 006
Documentation - 007
Duplicate Payment - 001
Duplicate Payment - 002
Duplicate Payment - 003
Duplicate Payment - 004
EDI - 001
EDI - 002
EDI - 003
EDI - 004
EDI - 005
Eligibility - 001
Eligibility - 002
Eligibility - 003
Eligibility - 004
Eligibility - 005
Other Insurance - 001
Other Insurance - 002
Other Insurance - 003
Other Insurance - 004
Other Insurance - 005
Other Insurance - 006
Other Insurance - 007
Other Insurance - 008
Other Insurance - 009
Pharmacy - 001
Pharmacy - 002
Pharmacy - 003
Pharmacy - 004
Pharmacy - 005
Proficency - 001
Proficency - 002
Proficency - 003
Proficency - 004
Provider - 001
Provider - 002
Provider - 003
Provider - 004
Provider - 005
Reimbursement - 001
Reimbursement - 002
Reimbursement - 003
Reimbursement - 004
Reimbursement - 005
Reimbursement - 006
Reimbursement - 007
Timeline - 001
Timeline - 002
Timeline - 003
Timeline - 004
Timeline - 005
Timeline - 006
Timeline - 007
Search
Error Level
Error Type
Payment Error
Overpaid
Underpaid
Adjustment
Business Team
SOP Referenced
Error Category
Error Code
Agree
Disagree
Remove Error
Uphold Error
Note
Error Detail
A: Agree, D: Disagree, R: Remove, U: Uphold C: Closed
All SME Questions are Confirmed.
0 Submitted
0 Replied
0 Confirmed
All Pend/Hold are Resolved.
0 Open
0 Released
All Review/Response are Completed.
0 Ready
0 Not Ready
0 File(s) Attached.
Transfer Reasons
Not Trained
Requested by Supervisor
Transfer Reason 1
Transfer Reason 2
Transfer Reason 3
Close Reasons
Administration Work
Close
End of Day
Priority Changed
Release as new
Released
Pending
Pend Reasons
Incorrect Document
Missing Benefit Summary
Missing Opt Out Letter
Missing Rate Sheet
Missing Source Document
Question to Quality Coach
System Hold
Auditor's Notes
Auditor Note