Lub Alliance yuav tsum xa cov ntaub ntawv ntsib mus rau Department of Health Care Services (DHCS). Txhawm rau ua raws li DHCS cov cai, tag nrho cov ntawv thov thawj thiab theem nrab rau Tus Kws Kho Mob Tswj Tshuaj (PAD) yuav tsum tau them nqi nrog tus tsim nyog, National Drug Code (NDC), chav ntsuas thiab ntau.
Cov chav ntsuas muaj xws li kev tsim nyog F2 (International Unit), GR (Gram), ML (Milliliter), thiab UN (Unit). Kuv yuav ua li cas xa daim ntawv thov uas suav nrog tus tsim nyog, NDC, chav ntsuas thiab qhov ntau?
- Hardcopy xa ntawm CMS-1500 daim ntawv thov:
- Qhov chaw ntxoov ntxoo ntawm lub thawv 24: nkag mus rau cov khoom ID tsim nyog (tawm qhov chaw & hyphens) thiab 11 tus lej NDC Ncaj nraim tom qab tus lej kawg ntawm NDC, nkag mus rau ob lub cim ntawm kev ntsuas kev tsim nyog ua raws li cov lej ntau.
- Piv txwv ntawm kev them nqi kom raug:
- Hardcopy xa rau ntawm UB-04 daim ntawv thov:
- Field 43: nkag mus rau cov khoom ID tsim nyog (tso tseg qhov chaw & hyphens) thiab 11-tus lej NDC Ncaj nraim tom qab tus lej kawg ntawm NDC, nkag mus rau ob lub cim ntawm kev ntsuas kev tsim nyog ua raws li tus lej ntau (Ib tus lej cuaj tus lej. Cov lej suav nrog rau tus lej rau tag nrho cov lej, ua raws li peb tus lej lej.)
- Piv txwv ntawm kev them nqi kom raug:
- Kev xa tawm EDI rau Cov Kws Tshaj Lij (837p) thiab Institutional (837i) Kev Thov:
Loop Ntu Lub Npe Lub Npe ib 2410 LIN Khoom lossis Kev Pabcuam ID Qualifier ib 2410 LIN Khoom lossis Kev Pabcuam ID ib 2410 CTP Ntau ib 2410 CTP Chav tsev lossis Basis rau Kev Ntsuas Code
Chav ntsuas thiab qhov ntau tam sim no tsis tas yuav tsum tau xa ncaj qha mus rau Alliance lossis DHCS raws li Medi-Cal cov lus qhia thiab yog li tshem tawm cov ntaub ntawv no yuav tsis ua rau tsis lees paub. Txawm li cas los xij, nyob rau yav tom ntej tsis ntev los no cov lus thov uas tsis muaj qhov ntsuas thiab qhov ntau yuav raug tsis lees paub. Qhov tsis kam lees yuav yog 522 – Tus kws kho mob muab cov ntaub ntawv tshuaj uas ploj lawm lossis tsis raug.
Daim ntawv teev npe no yog daim ntawv ceeb toom los txhawb cov neeg muab kev pabcuam kom hloov kho cov nqi tsim nyog tam sim no ua ntej cov ntawv sau nqi no thov tsis lees paub. Kev ceeb toom ntxiv ntawm qhov yuav tsum tau them nqi yuav raug xa tawm mus rau cov chaw muab kev pabcuam raws li peb cov qauv ceeb toom lub sijhawm.
Yog tias koj muaj lus nug lossis xav paub ntxiv, thov hu rau Alliance Claims department ntawm (800) 700-3874, ext. ib 5503.
