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Member Claims Transfer Page

You can transfer one or several claims from the source to the target member, provided you have the authority.

The Member Claims Transfer page contains the following panels:

 

Span Filter Fields

Field Description
To filter the information displayed on the current page by the indicated LOB, click Filter.
LOB The descriptive name of the line of business. Use this option to narrow your potential claims to be transferred display. Only claims whose LOB matches this field will display.

 

Source Information Fields

Field Description
None of these fields can be edited.
Member Name The source member's full name.
Internal System ID

The source member's internal system ID.

Note: This is a system generated, unique, sequential number.
SSN

The Social Security number of the source member.

A nine-digit number assigned by Federal government, usually assigned at the time of birth and used for tax purposes.

Note: If this field is all zeros, it displays as blank.
Date of Birth

The date the source member was born.

Format: MM/DD/YYYY

Gender The source member's gender, usually male or female. In some cases, the gender may also be unknown.

 

Target Information Fields

Field Description
The initial display only shows the Member ID and Member ID Type.
Member ID

A unique identifier assigned to a member.

Member ID Type

Unique code indicating the type of member identifier.

Examples: Medicare ID, MID New Heights, RID VISION and the Technical Eligibility Computer System (TECS) systems, SSN
Click Search to locate the target member ID. If found, additional fields are displayed. To select the target, in the table of potential targets identified by internal system IDs and name, click the appropriate row. The selected target's information is displayed.
Internal System ID The target member's internal system ID.
Member Name The target member's name.
SSN

The Social Security number of the target member.

A nine-digit number assigned by Federal government, usually assigned at the time of birth and used for tax purposes.

Note: If this field is all zeros, it displays as blank.
Date of Birth

The date the target member was born.

Format: MM/DD/YYYY

Gender The target member's gender, usually male or female. In some cases, the gender may also be unknown.

 

Potential Claims for Transfer Fields

Field Description
Select All Transfers If selected, indicates that all claims listed should be transferred from the Source to the Target member.
LOB The descriptive name of the line of business.
TCN

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

Note: This field links to the Claims Inquiry for the specific TCN displayed.
Claim Status

Indicates the status of the claim.

Examples: Paid, To Be Paid, Denied, To Be Denied
Claim Type

The type of claim.

Examples: Inpatient, Outpatient, Financial Transaction
Billing Prov ID

Unique identifier used for a provider of healthcare services, Generated by the system when the Provider Enrollment Application has been approved.

Note: This field links to the Provider Maintenance Name and Address page for the Billing Provider ID. If you hover over this field, the Provider Name is displayed.
First Date of Service The first date of service for the member's claim.
Billed Amt The billed dollar amount on the member's claim.
Reimbursed Amt The reimbursed dollar amount on the member's claim.
Transfer

If selected, indicates that the claim should be transferred from the source to the target member.

 

Version as of 5/16/14.

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