Health Care Services Review Response Defaults Section

Enter health care services review response information.

Avatar MSO > Care Management > Health Care Services Review (278) Defaults

1. The following fields create interchange and functional group header information in the 278 response file, and are set up in the Dictionary Update form (RADplus Utilities):

• Authorization Information Qualifier (ISA-01)
• Security Information Qualifier (ISA-03)
• Interchange Sender ID Qualifier (ISA-05)
• Interchange Receiver ID Qualifier (ISA-07)
• Acknowledgement Requested (ISA-14)
• Usage Indicator (ISA-15)

• The following fields are mapped to the Current Authorization Status Reason dictionary for pending or denial codes:

2. In the Add, Edit or Delete field, specify the operation to perform on the authorization status default information.

3. In the Authorization Status field, select the status.

4. In the Authorization Status Reason field, select the reason the authorization status was applied.

5. In the Rejection Level field, select the rejection level.

6. In the Status Code field, select the status code.

7. Click Update Authorization Status Reason.