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HealthCare Discrepancies and Error Indentification

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  1. Healthcare Discrepancies and Error Identification:

    The top portion of the page displays all of the discrepancies identified throughout the review.  All discrepancies may not necessarily cause eligibility errors.  The discrepancy which has the greatest impact on the case should be considered the primary error and entered as such in the bottom portion of this page.
     

  2. Error Identification:

    Provides detailed information regarding the error which has been identified as the primary error.

  

  1. Primary Error Type:  

 

Identify the type of error from the drop down list provided.  The error type refers to the entity responsible for the error.

 

  1. Error Element Code:  

    Identify the appropriate error element from the drop down list.  The element code refers to the eligibility element where the error occurred.  Type of error elements include but are not limited to:
     

  2. Error Cause:  

    Identify the appropriate cause code from the drop down list.  The cause code is the most specific entry to describe the error.  It describes what action occurred to cause the error.
     

  3. Comments:  

    Provide comments regarding case errors or discrepancies here.  If there is more than one significant error, provide the details of that error here as well.
     

 

 

This page last updated in Release Number: 08-02

Release Date: 04/03/08

Effective Date: 02/01/08