Help - Claim Confirmation

Section 111 Mandatory Reporting Application (MRA)

Claim Confirmation

This page shows all of the information you have entered for the claim on one page. The information is grouped in sections that represent the information entered on each page. Information in the Injured Party section cannot be changed. The Insurance Type and CMS Date of Injury (DOI) cannot be changed once a claim has been submitted. If you need to change this information, you will need to start with a new claim.

Review the information before you submit the claim. If you need to change any information you can click the Edit button next to the Injury section which will take you to the Injury Information page. Note: The Edit button is not available to claims in Deleted status.

Once the system displays the Injury Information page you can advance to any page that needs to be revised. If you make changes you will be required to page through the entire claim using the Next button to ensure your data has been entered correctly.

The following tables describe which command buttons are available depending on the status of the claim:

Table 1: Saved Not Submitted Status

Command	Description
Submit Claim	Changes the claim’s status to New and designates the claim to be processed in batch. If you have not previously submitted the claim, your transaction count will not decrease. If you are correcting an error on a claim that was returned with a disposition of SP (i.e., errors were returned on the claim submission), your transaction count will not decrease. If you are submitting changes to a completed claim, your transaction count will be reduced by one.
Cancel	Returns to the Cancel Edit page. If you click Cancel on this page, any unsaved information entered for the claim will be deleted and you will be returned to the Claim Listing page.
Save Updates	Saves all changes you have made to the claim. You can then submit the claim or wait to submit the updates until a later time. Claims in Saved Not Submitted status are maintained on the system for 30 days. After the 30 days elapse, the claim status will change to Deleted. You will have to enter the claim again if you still need to report the information, and your transaction count will be reduced by one.

Command

Description

Submit Claim

Changes the claim’s status to New and designates the claim to be processed in batch. If you have not previously submitted the claim, your transaction count will not decrease. If you are correcting an error on a claim that was returned with a disposition of SP (i.e., errors were returned on the claim submission), your transaction count will not decrease. If you are submitting changes to a completed claim, your transaction count will be reduced by one.

Cancel

Returns to the Cancel Edit page. If you click Cancel on this page, any unsaved information entered for the claim will be deleted and you will be returned to the Claim Listing page.

Save Updates

Saves all changes you have made to the claim. You can then submit the claim or wait to submit the updates until a later time. Claims in Saved Not Submitted status are maintained on the system for 30 days. After the 30 days elapse, the claim status will change to Deleted. You will have to enter the claim again if you still need to report the information, and your transaction count will be reduced by one.

Table 2: Completed or In Process Status

Command	Description
Cancel	Returns to the Cancel Edit page. If you click Cancel on this page, any unsaved information entered for the claim will be deleted and you will be returned to the Claim Listing page.
Save Updates	Will only display if changes have been made to the claim and the user has returned to the Claim Confirmation page. When this action is taken, the system will save all changes made to the claim. The status of the claim will change to Saved Not Submitted. You can then submit the claim or wait to submit the updates until a later time. Claims in Saved Not Submitted status are maintained on the system for 30 days. After the 30 days elapse, the claim status will change to Deleted. You will have to enter the claim again if you still need to report the information, and your transaction count will be reduced by one.
Submit Claim	Will only display if changes have been made to the claim and the user has returned to the Claim Confirmation page. When this action is taken, the claim's status changes to New and the claim will be processed in batch. If you are correcting an error on a claim that was returned with a disposition of SP, your transaction count will not decrease. If you are submitting changes to a completed claim, your transaction count will be reduced by one.

Command

Description

Cancel

Returns to the Cancel Edit page. If you click Cancel on this page, any unsaved information entered for the claim will be deleted and you will be returned to the Claim Listing page.

Save Updates

Will only display if changes have been made to the claim and the user has returned to the Claim Confirmation page.

When this action is taken, the system will save all changes made to the claim. The status of the claim will change to Saved Not Submitted. You can then submit the claim or wait to submit the updates until a later time. Claims in Saved Not Submitted status are maintained on the system for 30 days. After the 30 days elapse, the claim status will change to Deleted. You will have to enter the claim again if you still need to report the information, and your transaction count will be reduced by one.

Submit Claim

Will only display if changes have been made to the claim and the user has returned to the Claim Confirmation page.

When this action is taken, the claim's status changes to New and the claim will be processed in batch. If you are correcting an error on a claim that was returned with a disposition of SP, your transaction count will not decrease. If you are submitting changes to a completed claim, your transaction count will be reduced by one.

Table 3: New or Deleted Status

Claims in New status have already been submitted but have not been processed in the batch process. Any changes you make while the claim is waiting to be processed will be included in the same transaction.

Command	Description
Cancel	Returns to the Cancel New Claim page. If you click Cancel on this page, any unsaved information entered for the claim will be deleted and you will be returned to the Claim Listing page.