How to Transfer a Claim

You can transfer historical claims from one member to another when claims have been paid/denied for the incorrect Member ID. You normally do this when information and claims for separate IDs have been mistakenly assigned to the incorrect one.

The source member eligibility system (VISION and the Technical Eligibility Computer System (TECS) systems) separates the member information into the correct IDs. <<Is this first sentence accurate for ND? I think it isn't, but please confirm deletion or edit as needed. >> Using the Member Transfer Claims page in North Dakota MMIS Web Portal, you select the appropriate claims to transfer from the source to the target ID. You must have the permissions necessary to access the Claims Transfer function, and the source and target members must exist in the system.

Optionally, you can:

• View or add notes. To view or add notes for this record, on the action bar, click Notes.
• View audit details. To retrieve audit information, close any open panels and, on the action bar, click Audit Log. To view the details for a particular record, click Audit.
• Reset your entries. To clear the fields and remain on the page or panel, click Reset.
• Cancel your entries. To close the page or panel without saving your changes, click Cancel.

To transfer a claim

1. On the Member menu, click Transfer Claims.

   Tip: If you are already accessing a member's information on any Member page, you can use the Member Detail Links/Member Maintenance Links to navigate to the desired information without having to search again.

2. Search for the source member.

   Note: The source member is the member from whom the paid, to-be-paid, denied, and to-be-denied claims are being transferred. If no claims exist for the Source Member ID specified, you will get an error message.

3. Optionally, to limit the records displayed in the table, on the Member Claims Transfer page, in the Span Filters panel, complete the fields and click Filter.
4. To locate the target member ID, in the Target Information panel, complete the fields.

   1. Complete the Member ID and Member ID Type fields.

      Note: The Target Member ID identifies the member to whom the claims are to be transferred.

   2. Click Search.
   3. To select the target, in the table of potential targets identified by their internal system ID and name, click the appropriate row.
5. To choose which claim(s) to transfer from the source member ID to the target member ID, in the Potential Claims for Transfer panel, do one of the following:
   • To select all claims, select Select All Transfers.
   • To select individual claims, select the applicable Transfer check boxes.
   • To deselect a claim, clear the applicable check box. Selected claims display a check mark. When deselected, the check box displays as blank.
6. On the Member Claims Transfer action bar, click Save.

See Also

Member Claims Transfer Page

What Is Transfer Claims?

How to Search for a Member

What Is Claims Inquiry?

About Members

Version as of 5/16/14.