Note: You must have the authority, "Process Medicare Claim File Response," (Diamond Administration group) to access and run this function.
Once the Claim File is uploaded to CMS (Diamond Administration: Create Medicare Claim File), CMS then sends a response file back. The Process Claim File Response transfers the Disposition Codes to the Medicareclaimresponse table.
Open Diamond from your desk top
Right click the Diamond Agent caution sign in the right corner
Click Administration / Claims / Process Claim Response File
Click Browse and select the directory / file location.
Click Open.
Select Process Claim Response File.
Once the claim response file has been processed, run the Claim Medicare Response File Report. This report displays the information processed from the Medicare response file for a specific file submission date. The report can be filtered by disposition so that the user can only return data that is specific to failed records. This report should be used to determine errors in the Claims Submission file so that they can be corrected in the upcoming file submission.
Input parameters are:
File Submission Date
Disposition Code