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180 day timely filing exception req co 21290 014 - Coggle Diagram
180 day timely filing exception req
co 21290 014
Portal Changes
providers
Upload doc
180-day exception
not 180-day exception= ACN
Search/Req ACN
Account
NPI
Provider ID
Req exception?
Delay reason
Recipient Id
Action
Request
:pencil2:
Search
ACN form
view
print
Upload PDF Docs
ACN cover sheet
Up to 30 pages
If > 30 pages
Mail docs
Submit
Claim Window
2 New or Adj
Submit claim
Submit attachment
ATN
File
ACN
180 exception
Required
ACN cover
Supporting docs Iif any)
not enforced
180 day cover
Regular claim
Required
ACN Cover
Supp docs (if any)
Electronic
ACN
Detail page
required
not enforced
180 day
Easily identified ESC
Upload attachements
portal
mail attachment
Questions
Define new region code
Where to check region code
Right after timely filing edit
180 day post ESC
POST
Instead
timely filing
180 day Excempt
Regions
52
55
Void adj
Reprocess denial (non-180)
Because timely filing edit is to pay and list
Reprocess denial
180 day
Region 85
Denied again
Same ESC
Internet
ESC
New 180 ESC posted
Instead of timely filing
Excluded 180 day ex
Mass Adj
Void adj
Reprocess denial
non-180 day region
85
because is set to pay
180 day Region
85
will be denied again
same ESC as original
Current
Mail
Scan
Tables
t_attachment_xref_180_day
CDE_ATTACHMENT_CONTROL
180_DAY_RESP_CODE
t_reason_codes_180_day
SAK_180_DAY_REASON_CODE
180_DAY_REASON_CODE
180_DAY_REASON_DESC
t_decision_180_day
SAK_180_DAY_REASON_CODE :red_cross: sak_180_day_resp
SAK_ESC :red_cross: SAK_CLAIM
NUM_DTL
ADDTL_DESC
t_response_180_day
180_DAY_RESP_CODE
_DAY_RESP_DESC
t_adj_mass_rqst_180_day
NUM_MASS_RQST
180_DAY_FLAG
t_attachment_xref
sak_claim
cde_attachment_control
num_dtl
t_attachment_xref_180_day :red_flag:
Paper
ACN
Required
cover sheet
Optional
Detail page
Capture
Exception
If applicable
Received
180-day exception
No exception checked
Captutred as other
Process
Unchanged
180 day paper attachment
Regular paper attachment
180 day uploaded attachment
Regular uploaded attachments
Mailroom
Screening
Required
coversheet
supporting docs
if any
New paper region
Post new ESC
Instead of
timely filing edit
If no cover sheet
As regular claim
Excempt
reporcess denial
non 180 day
timely filing edit - pay and list
180 day
post same ESC
Adjustment
Required
Coversheet
Supporting Docs
if any
set flag
Set ESC
Instead of
timely filing
No coversheet?
As regular
DHS paper submission
paper image capture system
Operations
Mailroom
iCapture
Attachment
Unchanged
180 day exception - paper attachments
Regular paper attachments
180 day exception uploaded attachments
Regulat uploaded attachments
Recycle Process
180 day ESC posted
Instead of
timely filing
Excluded
Regions
52
55
Reprocess denial
non 180
Regions
80
85
180 day
Regions
80
85
Denied again same ESC
General
New ESC