Latest DCN

This is the document control number assigned by the system to identify a claim.
Each time you submit more information about a particular claim this number will be updated. The DCN is also a link to the detailed information about the claim. When clicked, it will take you to the Claim Confirmation page for submitted claims, or to page 2 of 6 in the claim entry flow (Injury Information Page) if the claim is in Saved Not Submitted status. You can only search on the most recent DCN for a claim. Click the History link under Actions to view prior DCNs for a claim.

TRX Cnt

Number of transactions or DCNs associated with this claim. This count represents the number of entries in the history.

Policy Number

The insurance policy number entered on the Insurance Information page.
Note: To ensure updates are applied to recovery cases appropriately, remember to submit this number uniformly with a consistent format . When sending updates, enter the policy number exactly as it was entered on the original submission, whether blank, zeros, or a full policy number.

Claim Number

Claim number assigned by the RRE/insurer

Medicare ID

HICN or MBI. This was the current Medicare ID when the claim was first submitted. If the beneficiary's Medicare ID changes before you need to make an update to your claim, you can still update the claim record with the older Medicare ID. The system will automatically link the old and new IDs to process the claim.
Note: This is also known as the Medicare Number to CMS’ Medicare beneficiaries.

Beneficiary Name

Name matched in the Beneficiary database.

CMS Date of Injury

Date of Incident (DOI) associated with the claim.

Initial Entry Date

Date that the claim was first entered. If multiple transaction updates have been applied it is the date of the first transaction.

Last Action

Last transaction type processed for the claim. Values are Add, Update, or Delete.

Status

Status of the last transaction. Values are Saved Not Submitted, New, In Process, Error, Completed or Deleted.

Disposition

Disposition of the last transaction. Values are:

01 - Record accepted, applied at CWF

02 - Record accepted no ORM reported

03 - Record accepted, but coverage period does not overlap with the injured party’s entitlement period

SP - Record received processing errors. (Errors can be reviewed at the bottom of the Claim Confirmation Page) Refer to the Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Worker’s Compensation User Guide on the CMS website for more information about errors. There is a link to this document in under References on the Menu Bar.

Actions

The Actions listed (Update, Delete, View, History and Resume) are hyper-linked to take you to the appropriate page to perform the actions for this claim. Click on the link to perform the desired action as defined below:

Update

Edit the information and create an update transaction to update or change information on your prior submission.

Delete

Set the status of a claim to deleted. This action should only be used if the record was created in error or should not have been submitted.

View

Look at the information in the claim.

History

View a record of the transactions associated with this claim.

Resume

Return to editing a record in Saved Not Submitted status.