You can use the Quick Search panel to find or confirm a code or ID needed to complete a field. The appropriate search filters and search results are displayed based on the field for which you requested the search.
The Quick Search panel contains a Quick Search panel and search results table based on the information for which you are searching:
At least one field must be entered to search.
| Field | Description |
|---|---|
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Quick Search Fields Complete the fields and click Search. |
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| ID | Unique identifier for the benefit plan. |
| Description |
The descriptive name of the benefit plan. Can be used with the Starts With or Contains option. |
| Starts With |
The Starts With option tells the system to retrieve all records that start with the search criteria entered. Example: If you entered the x-ray in the procedure description and selected the Starts With option, the search results would display all procedures that have descriptions starting with the word x-ray. |
| Contains |
The Contains option tells the system to retrieve all records that include the associated search field somewhere in the text. At least 2 characters must be entered to use the Contains option. Example: If you enter the phrase spine thoracic in the procedure description and select the Contains option, the search results may display 72072 (x-ray spine thoracic 3 views) and 72074 (x-ray spine thoracic 4+ views). |
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Search Results Fields To select one of the matches displayed in the table to complete the field, click the appropriate row. |
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| ID | Unique identifier for the benefit plan. |
| Description |
The descriptive name of the benefit plan. |
| Type |
The type of benefit plan. Examples: Fee for Service, HMO, Pharmacy, Managed Care |
| LOB |
The unique code that identifies the line of business, a high-level payer, or funding source such as Medicaid. |
| Begin Date |
The date the plan becomes effective. Must be earlier than or the same as the plan's ending date. Must be within the beginning and ending dates for the LOB. Format: MM/DD/YYYY |
| End Date |
The date after which the plan is no longer effective. Format: MM/DD/YYYY |
| Field | Description |
|---|---|
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Quick Search Fields Complete the fields and click Search. |
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| ID | The unique identifier of the organization responsible for the third-party policy. |
| Type |
The type of carrier. Examples: Health insurance, non-health, Medicare Part A, etc. |
| Name | The descriptive name of the organization responsible for the third-party policy. Can be used with the Starts With option. |
| Starts With |
The Starts With option tells the system to retrieve all records that start with the search criteria entered. Example: If you type Sm in the Name field and select the Starts With option, your results will include records with ames Smith and Smyth, but not McSmyth. |
| Contains |
The Contains option tells the system to retrieve all records that include the associated search field somewhere in the text. At least 2 characters must be entered to use the Contains option. Example: If you type Neil in a Name field and select the Contains option, your results will include records with names O'Neil and Neilson. |
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Search Results Fields To select one of the matches displayed in the table to complete the field, click the appropriate row. |
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| ID | The unique identifier of the organization responsible for the third-party policy. |
| Type |
The type of carrier. Examples: Health insurance, non-health, Medicare Part A, etc. |
| Name | The descriptive name of the organization responsible for the third-party policy. |
| Field | Description |
|---|---|
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Quick Search Fields Complete the fields and click Search. |
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| Code |
A standard code created by the International Classification of Diseases, Clinical Modification assigned to identify diseases, disorders, symptoms, and medical signs for inpatient and outpatient care, including physician offices and procedures (inpatient care). It is also used to measure morbidity (disease) and mortality (death). Can be used with the Starts With option. Format: For ICD-9 codes, usually a 3-digit code followed by a period and up to 2 additional digits. For ICD-10 codes, usually a 5-digit code, followed by a period and up to 2 additional digits. Examples: 515, 244.2, 292.85, V01.7, 7177 |
| Description |
The short description of the disease associated with the diagnosis code. Can be used with the Starts With or Contains option. Format: 40 characters or less Example: IODINE HYPOTHYROIDISM |
| Starts With |
The Starts With option tells the system to retrieve all records that start with the search criteria entered. Examples: If you enter 42 in the Diagnosis Code field and use the Starts With option, a list of diagnosis codes for diseases of the circulatory system, such as: 421 (Acute and subacute endocarditis), and 428.1 (pneumonia due to Hemophilus influenzae) would be returned. If you enter Botulism as the description with the Starts With option, the system displays all codes with the description starting with botulism, such as Botulism Food Poisoning. The result does not contain Infant Botulism and Wound Botulism since they do not start with the word botulism. |
| Contains |
The Contains option tells the system to retrieve all records that include the associated search field somewhere in the text. At least 2 characters must be entered to use the Contains option. Example: If you enter Botulism with the Contains option, the system will display all codes who descriptions contains botulism, such as Botulism Food Poisoning, Infant Botulism and Wound Botulism. |
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Search Results Fields To select one of the matches displayed in the table to complete the field, click the appropriate row. |
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| Code |
A standard code created by the International Classification of Diseases, Clinical Modification assigned to identify diseases, disorders, symptoms, and medical signs for inpatient and outpatient care, including physician offices and procedures (inpatient care). It is also used to measure morbidity (disease) and mortality (death). Format: For ICD-9 codes, usually a 3-digit code followed by a period and up to 2 additional digits. For ICD-10 codes, usually a 5-digit code, followed by a period and up to 2 additional digits. Examples: 515, 244.2, 292.85, V01.7 |
| Description |
The description of the disease associated with the diagnosis code. Format: 40 characters or less Example: Iodine Hypothyroidism |
| Field | Description |
|---|---|
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Quick Search Fields Complete the fields and click Search. |
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| Type | Indicates the type of exception code for which you are searching. Options are: Claim or Authorization. |
| Code |
A 4-digit code assigned to the claim or service authorization (SA) exception. Can be used with the Starts With option. Example: 0102 |
| Description | The short description describing with the exception. Can be used with the Starts With or Contains option. |
| Starts With |
The Starts With option tells the system to retrieve all records that start with the search criteria entered. Examples: If you enter 42 in the Diagnosis Code field and use the Starts With option, a list of diagnosis codes for diseases of the circulatory system, such as: 421 (Acute and subacute endocarditis), and 428.1 (pneumonia due to Hemophilus influenzae) would be returned. If you enter Botulism as the description with the Starts With option, the system displays all codes with the description starting with botulism, such as Botulism Food Poisoning. The result does not contain Infant Botulism and Wound Botulism since they do not start with the word botulism. |
| Contains |
The Contains option tells the system to retrieve all records that include the associated search field somewhere in the text. At least 2 characters must be entered to use the Contains option. Example: If you enter Botulism with the Contains option, the system will display all codes who descriptions contains botulism, such as Botulism Food Poisoning, Infant Botulism and Wound Botulism. |
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Search Results Fields To select one of the matches displayed in the table to complete the field, click the appropriate row. |
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| Code |
A 4-digit code assigned to the claim or SA exception. Example: 0102 |
| Description |
The short description describing with the claim pr SA exception. |
| Field | Description |
|---|---|
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Quick Search Fields Complete the fields and click Search. |
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ID |
The member's Alternate ID type code. This ID may be the member's MID, RID, or Medicare Number. Example: If the ID type is Medicaid ID, enter the 11-digit MID from VISION and the Technical Eligibility Computer System (TECS) systems. |
| ID Type |
The member's Alternate ID type code. Examples: ME - Medicaid ID, MM - MMIS ID, SN - Social Security number, |
| Last Name |
The last name of the member for whom you are searching. Can be used with the Starts With option. |
| First Name | The first name of the member for whom you are searching. Can be used with the Starts With option. |
| Starts With |
The Starts With option tells the system to retrieve all records that start with the search criteria entered. Example: If you type Sm in a Name field and select the Starts With option, your results will include records with ames Smith and Smyth, but not McSmyth. |
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Search Results Fields To select one of the matches displayed in the table to complete the field, click the appropriate row. |
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ID |
The member's Alternate ID type code. This ID may be the member's MID, RID, or Medicare Number. Example: If the ID type is Medicaid ID, enter the 11-digit MID from VISION and the Technical Eligibility Computer System (TECS) systems. |
| ID Type |
The member's Alternate ID type code. Examples: ME - Medicaid ID, MM - MMIS ID, SN - Social Security number, |
| Last Name |
The last name of the member for whom you are searching. |
| First Name | The first name of the member for whom you are searching. |
| DOB |
Date of Birth. The date the member was born. Format: MM/DD/YYYY |
| Field | Description |
|---|---|
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Quick Search Fields Complete the fields and click Search. |
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| Code |
The national drug code (NDC) for a drug. Can be used with the Starts With option. Example: 0008090001 |
| Name |
The name of the drug. Can be used with the Starts With option Example: Ibuprofen |
| Starts With |
The Starts With option tells the system to retrieve all records that start with the search criteria entered. Example: If 0369 is entered for NDC, all NDC codes starting with 0369 are displayed. If Levo is enteredfor the Drug Name, all drug names starting with Levo are displayed, such as: Levothyroxine, Levocarnitine, Levofloxacin Hemnibydrate. |
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Search Results Fields To select one of the matches displayed in the table to complete the field, click the appropriate row. |
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| Code |
The national drug code for a drug. Example: 0008090001 |
| Drug Name |
The name of the drug. Example: Ibuprofen |
| GCN |
The generic code number of a drug. Example: 35930 |
| GSN |
The generic sequence number of a drug. Example: 012080 |
| PTC |
The primary therapeutic class to which the drug belongs. |
| Field | Description |
|---|---|
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Quick Search Fields Complete the fields and click Search. |
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| Code |
Indicates the procedure or service provided. Healthcare Common Procedure Coding System (HCPCS) or Current Dental Terminology (CDT) codes are typically used. Can be used with the Starts With option. Example: 99213 |
| Description |
The short description of the procedure code. Can be used with the Starts With or Contains option. |
| Starts With |
The Starts With option tells the system to retrieve all records that start with the search criteria entered. Example: If you entered General in the plan description and selected the Starts With option, the search results would display all benefit plans starting with General, such as General Medical and General Dental. |
| Contains |
The Contains option tells the system to retrieve all records that include the associated search field somewhere in the text. At least 2 characters must be entered to use the Contains option. Example: If you enter the phrase medical in the description and select the Contains option, the search results may display plans such as General Medical or Medicaid Medical. |
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Search Results Fields To select one of the matches displayed in the table to complete the field, click the appropriate row. |
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| Code |
Indicates the procedure or service provided. Healthcare Common Procedure Coding System (HCPCS) or Current Dental Terminology (CDT) codes are typically used. |
| Description |
The short description of the procedure code. |
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M1 through M4 |
Modifier 1 - 4. A two-digit code attached to the procedure code to modify or clarify the description of the procedure. Up to four modifiers may be specified, if applicable. Example: SE, UD, U2 |
| Description |
The short description of the procedure code. |
| Field | Description |
|---|---|
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Quick Search Fields Complete the fields and click Search. |
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| Individual Last Name | The provider's last name. Can be used with the Starts With. |
| First Name | The provider's first name. Can be used with the Starts With. |
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ID |
A unique identifier used by a provider of healthcare services. |
| ID Type |
The ID type that is associated with the ID. Examples: DEA, NPI, SSN/EIN, UPIN, Medicaid, Medicare, NCPDP
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| Sort Name | The system-generated name based on the individual's name (Last, First, Middle) or the group's legal name that is used in search results and reporting. Can be used with the Starts With or Contains option. |
| Type |
The provider classification. Based on the Level I Provider Type of the Taxonomy Code Set. Examples: Dental, Pharmacy, Hospital, Vision, Physician |
| Specialty |
The provider's certified medical specialty. The provider specialty is based on the Level Ill Area of Specialization of the Taxonomy Code Set. Examples: Allergy, Blood Banking, Dentistry, Dermatology, Podiatry |
| Starts With |
The Starts With option tells the system to retrieve all records that start with the search criteria entered. Example: If you type Sm in the Sort Name field and select the Starts With option, your results will include records with ames Smith and Smyth, but not McSmyth. |
| Contains |
The Contains option tells the system to retrieve all records that include the associated search field somewhere in the text. At least 2 characters must be entered to use the Contains option. Example: If you type Neil in the Sort Name field and select the Contains option, your results will include records with names O'Neil and Neilson. |
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Search Results Fields To select one of the matches displayed in the table to complete the field, click the appropriate row. |
|
|
ID |
A unique identifier used by a provider of healthcare services. |
| ID Type |
The ID type that is associated with the ID. Examples: DEA, NPI, SSN/EIN, UPIN, Medicaid, Medicare, NCPDP
|
| P SYS ID | ??? |
| Provider Name | The system-generated name based on the individual's name (Last, First, Middle) or the group's legal name that is used in search results and reporting. |
| Type |
The provider classification. Based on the Level I Provider Type of the Taxonomy Code Set. Examples: Dental, Pharmacy, Hospital, Vision, Physician |
| Specialty |
The provider's certified medical specialty. The provider specialty is based on the Level Ill Area of Specialization of the Taxonomy Code Set. Examples: Allergy, Blood Banking, Dentistry, Dermatology, Podiatry |
| Taxonomy |
CMS defines the Taxonomy Codes as an administrative code set for identifying the provider type and the area of specialization for all health care providers. The code set is used in X12-278 Referral Certification and Authorization and the X12 837 Claim transactions. It is maintained by the National Uniform Claim Committee (NUCC). |
| Address | The provider's address. |
| Field | Description |
|---|---|
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Quick Search Fields Complete the fields and click Search. |
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ID |
The logon identifier assigned to the user to gain access to the application. |
| Last Name |
The last name of the user. Can be used with the Starts With option. Example: Jones |
| First Name |
The first name of the user. Can be used with the Starts With option. Example: Ida |
| Starts With |
The Starts With option tells the system to retrieve all records that start with the search criteria entered. Example: If you type Sm in a Name field and select the Starts With option, your results will include records with ames Smith and Smyth, but not McSmyth. |
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Search Results Fields To select one of the matches displayed in the table to complete the field, click the appropriate row. |
|
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ID |
The logon identifier assigned to the user to gain access to the application. |
| Last Name |
The last name of the user. Example: Jones |
| First Name |
The first name of the user. Example: Ida |
Version as of 5/16/14.
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