The CMBHS Pending Claims page and function allows the user to Search for claims that have not yet been submitted to DSHS. The Search can be conducted from the business entities’ administrative (parent level) for any service Location or from the service delivery Location. After using the Pending Claims Search function, the Pending Claims page displays a list of billable claims that can be submitted to DSHS. When a claim has been submitted, it no longer appears on the Pending Claims page. The Pending Claims page is #CLM068.
The CMBHS Submitted Claims page and function allows the user to view and search claims that have been submitted to DSHS for payment. The Submitted Claims page displays a list of claims that haBefore You Startve been submitted by the provider to DSHS and from this page, the status of the claim can be monitored as it moves through the payment process. The Submitted Claims page is #CLM069.
Before You Start
- The CMBHS business entities’ contract with DSHS specifies the type of claim the provider is to submit for payment for services they have provided to client that are fully or partially funded by DSHS.
- The CMBHS user must be assigned a CMBHS role that allows use the Claim function.
- To submit a claim to DSHS for services provided to a client, the client must have a profile in CMBHS, must be admitted to the provider organization and must have received services that are documented in progress notes or day rate attendance records in CMBHS.
- Before you document in a client record or submit a claim for a client, always verify that you have the correct client by checking the client’s name and at least one other identifier.
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