MMIS RECIP PD/DENY - CRPC

The CRPC panel displays all claims (not in suspended status) that match search criteria entered on the CINQ panel.

Table of MMIS RECIPIENT PAID/DENIED - CRPC claims panel 
 NEXT:                         MMIS RECIP PD/DENY - CRPC                  
 RECIP ID: 00000000   LAST: LAST                  FIRST: FIRST           MI: I 
 COS:         MSG:       PROC CD:                 REVENUE CD:                   
 MODIF:       EXC:     PROV TYPE:      BILLED AMOUNT:                           
               FIRST  LAST  WARRANT REIMBURSEMENT CLM CLM  MJR TRANSACTION   +/-
 NBR PROV NBR  DOS    DOS    DATE       AMOUNT    ST  TYP  PGM CONTROL NUMBER   
 01 000000000  MMDDYY MMDDYY                0.00   I   V   MA 00000000000000000 
 02 000000000  MMDDYY MMDDYY                0.00   I   V   MA 00000000000000000 
 03 000000000  MMDDYY MMDDYY                0.00   I   V   MA 00000000000000000 
 04 000000000  MMDDYY MMDDYY MMDDYY       000.00   N   O   MA 00000000000000000 
 05 000000000  MMDDYY MMDDYY MMDDYY       000.00   N   O   MA 00000000000000000 
 06 000000000  MMDDYY MMDDYY MMDDYY         0.00   P   O   MA 00000000000000000 
 07 000000000  MMDDYY MMDDYY MMDDYY         0.00   P   V      00000000000000000 
 08 000000000  MMDDYY MMDDYY MMDDYY       000.00   N   A   MA 00000000000000000 
 09 000000000  MMDDYY MMDDYY MMDDYY        00.00   N   A   MA 00000000000000000 
 10 000000000  MMDDYY MMDDYY MMDDYY       000.00   N   A   MA 00000000000000000 
 11 000000000  MMDDYY MMDDYY MMDDYY         0.00   P   P      00000000000000000 
 12 000000000  MMDDYY MMDDYY MMDDYY         0.00   P   P      00000000000000000 
 13 000000000  MMDDYY MMDDYY MMDDYY         0.00   P   P   MA 00000000000000000 
 14 000000000  MMDDYY MMDDYY MMDDYY         0.00   P   P   MA 00000000000000000 
 15 000000000  MMDDYY MMDDYY MMDDYY         0.00   P   P   MA 00000000000000000 
 ENTER--PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10---PF11---PF12
 PAGE              S/EXT NAVIG       N/EXT PREV  NEXT         OOPS

Fields on the CRPC panel

PROVIDER NBR is the provider that will receive payment.

FIRST DOS is the first date of service on the claim.

LAST DOS is the last date of service on the claim.

WARRANT DATE is the date a claim was processed through the warrant cycle and the date on which a payment was generated.

REIMBURSEMENT AMOUNT the total amount paid to the provider for a claim

CLM ST the claim status. Most common status codes are K=to be denied, I=to be paid, P=denied and N=paid.

CLM TYPE a code the identifies the type of claim entered. Some of the claim types are listed below.

    • A=CMS-1500
    • C=Inpatient (UB-04)
    • D=dental
    • L=gross adjustment
    • M=medical supply
    • N=nursing facility-ICF/DD
    • O=outpatient
    • P=pharmacy
    • T=Medicare LTC crossover
    • U=Medicare Part A crossover
    • V=Medicare Part B crossover (CMS-1500)
    • W=Medicare Part B crossover (UB-04)
    • Z=credit request
    • 3=capitation (PPHP/MRRP)

MJR PGM identifies the primary medical care program in which the recipient participates. Examples are: MA=Medicaid, AC=alternative Care, QM=Qualified Medicare Beneficiary, UN=Unknown and BB=Minnesotacare Adults.

TRANSACTION CONTROL NUMBER is the unique number identifying a claim.

How to navigate the CRPC panel

  1. To view a claim on the CRPC panel press the down arrow key until the cursor rests on white text somewhere on the claim line you wish to view.
  2. Press function key F4 to display first screen of claim selected.
  3. TRANSMIT to advance through the screens in the claim queue.
  4. Press function key F6 to return to the CRPC panel to select a different claim to view or
  5. Press F8 to advance to additional pages of the list when the + or +/- is displayed.
  6. Press F7 to return to the previous page of the list when the - or +/- is displayed.
  7. To return to the CINQ panel from the CRPC screen, press F6.

Next we will look at a Type A CMS-1500 claim in the CLAIM PROCESSING subsystem.

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