Claim Status Inquiry/ Same or Similar

Medicare DME Real-Time Claim Status Inquiry (including “Same or Similar”)

Real-Time Claims Status Inquiry (CSI) allows you to electronically check the status of production claims after they have passed the front-end edits and received Claim Control Numbers (CCN). Through CSI, you will know if your claim has been paid, denied, or pending. At least three working days after you successfully file a claim, you will be able to locate your claim in the processing cycle. Payment information is available for both electronic and paper claims. Also through CSI, you are able to receive payable Certificates of Medical Necessity (CMN) Information – this function will tell you if your patient has been issued the “Same or Similar” equipment by another provider.

What information can you get from CSI?

CSI is divided into three main functions. These functions are:

CMN Status Information (including “Same or Similar”)

View Sample Response

This function allows users to view payable Certificates of Medical Necessity (CMNs) for specific beneficiaries, for specific Healthcare Common Procedure Coding System (HCPCS) codes. This will provide the following information when a same or similar HCPCS code is found in the common working file or the DME Jurisdiction’s local records:

Claims History Information

View Sample Response

Pending Claims Information

View Sample Response

Call Cortex EDI for more details at (800) 485-5977 or email