Focus on resolving the problem(s) identified in the screening process. That is, review
the claim’s material related to the problem identified.
Ordinarily, the CA review is limited to:
Applicable queries (e.g., Master Beneficiary Record (MBR), Payment History Update
System (PHUS), etc.);
The latest electronic or paper report of contact (RC) in file;
The printed transmittal screen or paper form; and
The current claims determination action.
NOTE: Review of the decision (DECI), interface (INTE), notice (NOT2 and NOT3) screens is
You must indicate that you performed a limited review on a District Office Final Authorization
(DOFA) claim. Annotate electronically the claims file with the remark “CA/LR”, the CA's initials and the date when the review was done.