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THIS FORM IS FAXED TO YOU DAILY SO THAT YOU MAY SEE WHERE YOUR MONEY IS IN THE PAYMENT PROCESS. THIS SCREEN IS DOWNLOADED DIRECTLY FROM THE MEDICARE COMPUTER SYSTEM |
| SUPPLIER NUMBER: ( YOUR SUPPLIER NUMBER ) | |||||
| AMOUNT PENDING ON PAYMENT FLOOR: $39,778.65 |
# OF CLAIMS ON FLOOR: 47 |
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CURRENT PAYMENT HISTORY ( THIS PORTION AVAILABLE IN REGION "C" ONLY ) |
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| DATE: | 1999/10/04 | 1999/09/30 | 1999/09/29 | ||
| $5,198.16 | $1,544.97 | $17,900.56 | |||
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# OF CHECKS |
1 |
1 |
2 |
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| NOTE: MULTIPLE CHECKS CAN BE CUT ON ANY GIVEN DAY | ||||||
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CLAIMS SUBMITTED | AMOUNT | ||||
| QUERY SUSPENSE | 25 | $47,553.02 | ||||
| OTHER SUSPENSE | 29 | $45,152.46 | ||||
| COMPLETED HELD | 47 | $55,572.11 | ||||
| TOTAL | 101 | $148,277.59 | ||||
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(813) 837-2773 · 1 (800) 813-2773 · FAX: (813) 832-3392 |
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