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What Is a Claim History Request?

You use the History Request page to set up requests for ND MMIS to retrieve claims from the archived claims database, to trigger a “targeted” Explanation of Medical Benefits (EOMB) letter to be sent to a member(s), or request a history profile. You set up history requests to support audit, adjustment processing, and other processing requirements.

Once you set up the request, the next time the archive retrieval process runs, the ND MMIS retrieves a copy of the claims that met the request criteria and places them in the claims history database. If the request was for an EOMB, a “targeted” EOMB is sent to the member(s) to describe services paid on the member’s behalf. The claims will remain in claims history for a minimum of 90 days before they are re-archived.

 

Instructions

How to Search Claim History Request

How to Add or Edit a History Request

 

Field Descriptions

Claim History Request Search Page

Claim History Request Page

 

See Also

About Claims

 

Version as of 5/16/14.

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