MMIS CLM INQ KEY PNL- CINQ

The CINQ panel is the key panel for MMIS CLAIMS INQUIRY. The values entered or selected on this screen result in MMIS creating a list of claims meeting the criteria, from which the worker can navigate to view a particular claim.

In the table below the search criteria entered is ALL CLAIMS in section 1 and RECIPIENT ID in section 2. MMIS will search for and list all claims for this recipient.

Table of MMIS CLAIMS INQUIRY KEY PANEL - CINQ 
 NEXT:                        MMIS CLM INQ KEY PNL-CINQ                  
  1.  ENTER AN "X" BESIDE THE DESIRED SELECTION:                                
      X ALL CLAIMS                           SUSPENDED CLAIMS                   
        TO BE PAID/TO BE DENIED CLAIMS       CLAIMS HISTORY                     
        VOID/CREDIT REQUEST HISTORY                                             
  2.  ENTER ONE OF THE FOLLOWING KEY FORMATS TO BE USED FOR SEARCH:             
      A.  TRANSACTION CONTROL NUMBER:                                           
      B.  NPI:               PAY-TO/SUBMIT:    TREAT/CONTRACT:                  
      C.  RECIPIENT ID:00000000                                                 
      D.  MHCP PROVIDER:               PAY-TO/SUBMIT:    TREAT/CONTRACT:        
      E.  ICN:                                                                  
  3.  ADDITIONAL SEARCH CRITERIA FOR PROVIDER OR RECIPIENT SEARCH:              
        NPI:              MHCP PROV:              RECIPIENT ID:                 
       DATE OF SERV:                            PROCEDURE CODE:                 
       WARRANT DATE:                                  MODIFIER:                 
       REIMB AMOUNT:                              REVENUE CODE:                 
   CATEGORY OF SERV:                                CLAIM TYPE:     STATUS:     
     EXCEPTION CODE:                             MN SERV GROUP:                 
     PRESCRIPTION #:                          PPHP CONTRACT ID:                 
   PAYMENT TYPE: A  C=CONTRACT E-ENCOUNTER F-FEE FOR SERVICE A=ALL (DFLT)       
  4. ENTER LEVEL OF DETAIL INDICATOR:     D=DETAIL S=SUMRY (DFLT) P=PROC SUMRY  
 ENTER---PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10---PF11--PF12
 PAGE               S/EXT             N/EXT                   OOPS

Fields in section 1 of the CINQ panel

ALL CLAIMS searches for all claims that meet other criteria entered.

SUSPENDED CLAIMS lists only suspended claims that meet the other search criteria.

TO BE PAID/TO BE DENIED lists claims that have been processed but have not completed the warrant cycle yet.

CLAIMS HISTORY displays claims history.

VOID/CREDIT REQUEST HISTORY displays replacement claims.

Fields in section 2 of the CINQ panel

TRANSACTION CONTROL NUMBER (TCN) is a unique numeric identifier for a claim and identifies the specific claim to be viewed. The HIPPA name for TCN is Payer Control Number (PCN).

NPI is the National Provider Identifier (NPI) for the provider or group. Entering an NPI number will present all active claims for that provider. PAY-TO/SUBMIT and TREAT/CONTRACT fields are optional and entered if relevant to the search.

RECIPIENT ID is PMI number identifying an individual eligible for Medicaid benefits. Entry of PMI in this field selects all claims for this recipient.

MHCP PROVIDER is the provider identifier assigned by MHCP. HIPAA has since replaced MHCP provider numbers with NPI numbers for providers. In MMIS claims can still be searched by MHCP Provider number in some cases. Entry of provider number in this field selects all claims for this provider.

Fields in section 3 of the CINQ panel

NPI, MHCP PROV and RECIPIENT ID are the same as section 2.

DATE OF SERVICE is the first or only date of service and narrows the search results to a specific date or beginning time period.

PROCEDURE CODE and MODIFIER fields narrows claim search to a specific procedure code and is most effective for a recipient or provider search.

WARRANT DATE is the date a claim was processed through the warrant cycle and narrows search to a certain time period.

REIMB AMOUNT is the total amount paid to the provider for a claim and is used for inquiries where a specified amount is in question.

REVENUE CODE identifies a specific accommodation, ancillary service or billing calculation.

CATEGORY OF SERVICE aids in categorizing search results or selecting a specific group of claims.

CLAIM TYPE identifies the type of claim and sorts search results for one particular claim type.

STATUS is the current status of a claim.

EXCEPTION CODE sets search results to match a specific error posted on the claim in the adjudication cycle

MN SERVICE GROUP is another method for defining search by provider group.

How to use the CINQ key panel for claims inquiry

  1. Type X to select a group of claims from Section 1. In this example ALL CLAIMS is selected.
  2. In Section 2 enter identifier in one of the fields. In this example RECIPEINT ID is entered.
  3. Additional search criteria may be entered in Sections 3 and 4.
    • Completing Section 3 can be very helpful to limit search.
    • Adding D (DETAIL) to Section 4 allows claims to appear one at a time. This allows the use of the F4 function key within the claim screens.
  4. TRANSMIT to the next MMIS screen.
    • Claims in suspended status are listed on the CRCS screen.
    • All other claims are listed on the CRPC screen.

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