Medical Service Questionnaire Maintenance Page

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The Medical Service Questionnaire Maintenance page contains the following panels:

Span Filter Fields

Field	Description
To limit the information displayed on this page based on the information you enter in these fields, complete at least one of the fields and click Filter.
From Date	The beginning date in your filter. If entered, this field filters the data displayed on the current page. ND MMIS displays any dated span that overlaps the Search From and To Dates by at least one day.
To Date	The ending date in your filter. If entered, this field filters the data displayed on the current page. ND MMIS displays any dated span that overlaps the Search From and To Dates by at least one day.
LOB	The line of business. This field filters the information displayed on the current page based on which LOB you choose. ND MMIS displays any span of data whose LOB matches the one entered in this field. Example: MED-Medicaid

Field

Description

To limit the information displayed on this page based on the information you enter in these fields, complete at least one of the fields and click Filter.

From Date

The beginning date in your filter. If entered, this field filters the data displayed on the current page. ND MMIS displays any dated span that overlaps the Search From and To Dates by at least one day.

To Date

The ending date in your filter. If entered, this field filters the data displayed on the current page. ND MMIS displays any dated span that overlaps the Search From and To Dates by at least one day.

LOB

The line of business. This field filters the information displayed on the current page based on which LOB you choose. ND MMIS displays any span of data whose LOB matches the one entered in this field.

Example: MED-Medicaid

MSQ List Fields

Field	Description
To add an MSQ, click Add MSQ. To edit an MSQ, in the table, click the appropriate row. To view the claim associated with an MSQ, in the table, click the TCN link.
MSQ List Fields
Member ID	The member's unique, individual identifier in ND MMIS. ND MMIS captures many different identifiers (known as "Alternate IDs") for a member and selects one (known as the Member ID) that is used on all displays, reports, correspondence, etc. This field is view-only.
Member ID Type	The identifier type associated with the Member ID. This field is view-only. Examples: 12345678901 if Member ID type is MID, 123456789 if Member ID is SSN.
Member Name	The member's name. This field is view-only.
Stop MSQs	Indicates whether to stop MSQs or not. If Yes, then you cannot add an MSQ or force an MSQ to generate. This field is view-only.
Medical Service Questionnaire Fields
TCN	The transaction control number (TCN) is a unique number assigned by the ND MMIS to each claim. This field cannot be changed after it is saved the first time. When editing, links to the details of the claim associated with this MSQ.
MSQ Type	The type of MSQ being processed. This field cannot be changed after it is saved the first time. Examples: General, Auto, Worker's Compensation
Medical Service Date	The date the member received medical service. This field cannot be changed after it is saved the first time.
Manual Request	Indicator for whether the MSQ was manually requested and not automatically generated. This field is view-only.
Request Processed	Indicates whether the MSQ request has been processed. This field is view-only.
Included in MSQ	Indicates if the information was included in the MSQ. This field is view-only.
1st Notice	The first date the MSQ was processed. This field is view-only. Links to the corresponding document.
2nd Notice	The second date the MSQ was processed. This field is view-only. Links to the corresponding document.
Non-Response Notification	The date the non-response notification was processed. This field is view-only.
Response Date	The date the member responded. If a date is displayed, the label links to the corresponding document.
Return Response	The return response for the MSQ.
Reimbursement Amount	The reimbursement amount. This field is view-only.
Force MSQ?	Yes indicates that the MSQ is to be sent to the member even if other circumstances would normally keep one from being generated (such as an active recovery case or an MSQ has already been sent). No allows the normal business rules to apply and may mean that an MSQ is not generated at this time if one has already been sent within the number of days specified by a system parameter. Note: If the Request Processed field or the Stop MSQ field is Yes, this field cannot be edited.

Field

Description

To add an MSQ, click Add MSQ. To edit an MSQ, in the table, click the appropriate row. To view the claim associated with an MSQ, in the table, click the TCN link.

MSQ List Fields

Member ID

The member's unique, individual identifier in ND MMIS. ND MMIS captures many different identifiers (known as "Alternate IDs") for a member and selects one (known as the Member ID) that is used on all displays, reports, correspondence, etc. This field is view-only.

Member ID Type

The identifier type associated with the Member ID. This field is view-only.

Examples: 12345678901 if Member ID type is MID, 123456789 if Member ID is SSN.

Member Name

The member's name. This field is view-only.

Stop MSQs

Indicates whether to stop MSQs or not. If Yes, then you cannot add an MSQ or force an MSQ to generate. This field is view-only.

Medical Service Questionnaire Fields

TCN

The transaction control number (TCN) is a unique number assigned by the ND MMIS to each claim.

This field cannot be changed after it is saved the first time.

When editing, links to the details of the claim associated with this MSQ.

MSQ Type

The type of MSQ being processed. This field cannot be changed after it is saved the first time.

Examples: General, Auto, Worker's Compensation

Medical Service Date

The date the member received medical service. This field cannot be changed after it is saved the first time.

Manual Request

Indicator for whether the MSQ was manually requested and not automatically generated. This field is view-only.

Request Processed

Indicates whether the MSQ request has been processed. This field is view-only.

Included in MSQ

Indicates if the information was included in the MSQ. This field is view-only.

1st Notice

The first date the MSQ was processed. This field is view-only. Links to the corresponding document.

2nd Notice

The second date the MSQ was processed. This field is view-only. Links to the corresponding document.

Non-Response Notification

The date the non-response notification was processed. This field is view-only.

Response Date

The date the member responded. If a date is displayed, the label links to the corresponding document.

Return Response

The return response for the MSQ.

Reimbursement Amount

The reimbursement amount. This field is view-only.

Force MSQ?

Yes indicates that the MSQ is to be sent to the member even if other circumstances would normally keep one from being generated (such as an active recovery case or an MSQ has already been sent).

No allows the normal business rules to apply and may mean that an MSQ is not generated at this time if one has already been sent within the number of days specified by a system parameter.

Note: If the Request Processed field or the Stop MSQ field is Yes, this field cannot be edited.

Attachments Fields

Field	Description
To add an attachment, To attach documents from a local computer, click Add Attachments and in the Attachment panel, click Browse. To search and attach documents from the Electronic Document Management System (EDMS), click Search Document Repository. To edit, in the Attachments table, click the appropriate row. To remove the association to an attachment, on the Attachment action bar, click Detach. The document remains in the Attachment table, but the hyperlink is removed.
Date Added	The date an attachment was added to a record such as a case record, CR, or third-party liability record. This field is only displayed when editing and cannot be changed.
Added By	The user that added the attachment. This field is only displayed when editing and cannot be changed.
File Name or File	The name of the attached document. When adding, it is automatically displayed after the document is selected.
Description	An explanation of what the attachment is about. If the record to which the document is attached is closed, this field cannot be changed.
Attached	When editing, indicates if the document is currently attached to the record.

Field

Description

To add an attachment,

To attach documents from a local computer, click Add Attachments and in the Attachment panel, click Browse.
To search and attach documents from the Electronic Document Management System (EDMS), click Search Document Repository.

To edit, in the Attachments table, click the appropriate row. To remove the association to an attachment, on the Attachment action bar, click Detach. The document remains in the Attachment table, but the hyperlink is removed.

Date Added

The date an attachment was added to a record such as a case record, CR, or third-party liability record. This field is only displayed when editing and cannot be changed.

Added By

The user that added the attachment. This field is only displayed when editing and cannot be changed.

File Name or File

The name of the attached document. When adding, it is automatically displayed after the document is selected.

Description

An explanation of what the attachment is about. If the record to which the document is attached is closed, this field cannot be changed.

Attached

When editing, indicates if the document is currently attached to the record.