Submissions
- How should partially denied claims (paid claims containing denied lines) be submitted?
- Will gender codes be standardized across all three files?
- Does CIVHC expect that the data fields to be submitted in field number order, or, in the logical order given in the Submission Guide?
- What is the threshold guidance for column MC107?
- What value should appear in the Payer Code columns?
- Do Version Numbers ( MC005A) need to be consecutive?
- Should only paid and discharged claims be included?
- What is the guidance for MC055 (Procedure Code) for institutional claims?
- What is the guidance for columns MC065 (Co-pay Amount) and MC066 (Coinsurance Amount)?
- What is the guidance for columns marked as O (Optional)?
- Should all detail lined be supplied for a paid claim?
- What column names should be supplied in the first row?
- What are the definitions for MP003 (Provider Entity)?
- Values for column MC054 (Revenue Code), a required column, are not available for professional claims. Should we apply for a variance for this deficiency?
- What is the guidance for column MC055 (Procedure Code) where payments are made based on Revenue Code?
- What is the guidance for MC058 ( ICD-9-CM Procedure Code)?
- What is the column delimiter?
- Do Colorado license numbers need to be prefixed with the state code?
- What is the proper coding for dependents over age 18?