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# | Location | File | Last Modified |
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1 | CCRS.zip\CCRS\CCRS-BUSRULES-v1.5.3.zip\CCRS-BUSRULES-v1.5.3-436e6fff1115001d614ccd45b469ad60a9bdb27b\docs | CCRS Reimbursement Rule Inputs.xls | Tue Apr 10 06:18:41 2018 UTC |
2 | CCRS.zip\CCRS\CCRS-BUSRULES-v1.5.3.zip\CCRS-BUSRULES-v1.5.3-436e6fff1115001d614ccd45b469ad60a9bdb27b\docs | CCRS Reimbursement Rule Inputs.xls | Fri Jun 15 15:07:07 2018 UTC |
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1 | SHEET: She et1 | |
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4 | , , , , CC RS Databas e Table an d Fields t o Use (by claim type ) | |
5 | , Rule, De scription, Data Inpu ts, Profes sional, In stitutiona l, Dental, Pharmacy | |
6 | , Referral #, Confir m that the referral number on an 837 inv oice has a matching referral n umber from CCRA, Inv oice Refer ral # | |
7 | CCRS Refer ral #, DIM _VA_CLAIM. preauth_nu mber, DIM_ VA_CLAIM.p reauth_num ber, DIM_V A_CLAIM.pr eauth_numb er, DIM_VA _CLAIM.pre auth_numbe r | |
8 | , Timely F iling, The CCNs must transmit the invoic e to VA wi thin 180 d ays from t he invoice date of s ervice; or , Invoice Transmissi on Date | |
9 | Invoice Da te of Serv ice, DIM_V A_CLAIM.cl aim_create _date | |
10 | F_PROFESSI ONAL_MEDIC AL_CLAIM_D ETAILS.dat e_of_servi ce_from, D IM_VA_CLAI M.claim_cr eate_date | |
11 | DIM_INSTIT UTIONAL_CL AIM.statem ent_date_f rom, DIM_V A_CLAIM.cl aim_create _date | |
12 | F_DENTAL_M EDICAL_CLA IM_DETAILS .date_of_s ervice_fro m, DIM_VA_ CLAIM.clai m_create_d ate | |
13 | F_PHARMACY _MEDICAL_C LAIM_DETAI LS.date_of _service_f rom | |
14 | , , The CC Ns must tr ansmit the invoice t o VA withi n 30 days after CCN has paid t he provide r; or, Inv oice Trans mission Da te | |
15 | Invoice Pr ovider Pai d Date, DI M_VA_CLAIM .claim_cre ate_date | |
16 | F_PROFESSI ONAL_MEDIC AL_CLAIM_D ETAILS.pai d_date, DI M_VA_CLAIM .claim_cre ate_date | |
17 | F_INSTITUT IONAL_MEDI CAL_CLAIM_ DETAILS.pa id_date, D IM_VA_CLAI M.claim_cr eate_date | |
18 | F_DENTAL_M EDICAL_CLA IM_DETAILS .paid_date , DIM_VA_C LAIM.claim _create_da te | |
19 | F_PHARMACY _MEDICAL_C LAIM_DETAI LS.paid_da te | |
20 | , , The CC N’s must r e-transmit a rejecte d invoice to VA with in 30 days of initia l rejectio n, Invoice Transmiss ion Date | |
21 | Invoice In itial Reje ct Date, D IM_VA_CLAI M.claim_cr eate_date | |
22 | F_PROFESSI ONAL_MEDIC AL_CLAIM_D ETAILS.rej ect_date, DIM_VA_CLA IM.claim_c reate_date | |
23 | F_INSTITUT IONAL_MEDI CAL_CLAIM_ DETAILS.re ject_date, DIM_VA_CL AIM.claim_ create_dat e | |
24 | F_DENTAL_M EDICAL_CLA IM_DETAILS ..reject_d ate, DIM_V A_CLAIM.cl aim_create _date | |
25 | F_PHARMACY _MEDICAL_C LAIM_DETAI LS..reject _date | |
26 | , Date of Service, V alidate th at the inv oice date of service falls wit hin the re ferral’s v alid date ranges, In voice Date of Servic e | |
27 | Referral S tart Date | |
28 | Referral E nd Date, F _PROFESSIO NAL_MEDICA L_CLAIM_DE TAILS.date _of_servic e_from, DI M_INSTITUT IONAL_CLAI M.statemen t_date_fro m, F_DENTA L_MEDICAL_ CLAIM_DETA ILS.date_o f_service_ from, F_PH ARMACY_MED ICAL_CLAIM _DETAILS.d ate_of_ser vice_from | |
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30 | SHEET: She et2 | |
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34 | SHEET: She et3 | |
35 |
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