Forms must be keyed in all CAPITAL
LETTERS.
“Key what you see” means to literally key what you see. You are trying to replicate the form as it was submitted; you cannot fix errors.
“Key what you see” means to literally key what you see. You are trying to replicate the form as it was submitted; you cannot fix errors.
H23_Prior_Authorization_No
H23_Prior_Authorization_No
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Key what you see.
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H24a_Date_Of_Service_From
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Hyphens,
spaces, periods and slashes are optional.
If the
year is four digits, set four digits. If the year is two digits, set two
digits. If the month or day is NOT two digits, either add a zero to make it
two digits or add hyphens, spaces, periods or slashes.
Date
fields should NOT contain alphabetic characters. If a date is spelled out
(e.g., May 1, 1984), change it to numbers. If any text appears in the field
(e.g., STILL IN), do NOT key.
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H24a_Date_Of_Service_From- Examples:
As it appears on
form:
|
Acceptable
entries:
|
||||
02/04/1972
|
02/04/1972
|
02-04-1972
|
02 04 1972
|
02.04.1972
|
02041972
|
1 08 69
|
1/08/69
|
1-08-69
|
1 08 69
|
1.08.69
|
010869
|
May 1, 1984
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5/1/1984
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5-1-1984
|
5 1 1984
|
5.1.1984
|
05011984
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