MSO EOB Message Customization

Create custom messages to display in place of the system generated messages in the Explanation of Coverage fields in the Fast Service Entry, and claims processing forms.

Avatar MSO > System Maintenance > MSO EOB Message Customization

• These messages populate the Explanation of Coverage Section in the 837 Health Care Claim Professional, and 837 Health Care Claim Institutional form.

1. In the Message Type field, select the message type

• 'Approved/Pending/Denied' rules - the service is denied because it is not covered by the benefit plan.

• 'Miscellaneous' rules - the service is denied for reasons not associated with the benefit plan.

2. In the Message Rule field, select the message.

3. The Default Message field displays the message rule text.

4. In the Custom Message field, enter the message to display in place of the default message.

5. In the Adjustment Code field, select the adjustment code.

6. Click File.

• New CAS segments will be added to loop 2110 in 835 files during claim adjudication for:

• Services associated to an adjustment code.

• Reason codes with a zero adjustment amount.