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<div class="shell-navmenu"> <div class="panel panel-default col-xs-12 col-sm-12 col-md-12 col-lg-12 padding-horizontal-none text-primary" style="float: left; width: 100%"> <div class="panel-body"> <table width="100%" border="0" cellspacing="0" cellpadding="0"> <tbody> <tr> <td rowspan="2"><table border="0" cellspacing="0" cellpadding="0"> <tbody><tr> <td nowrap="nowrap" style="width: 245px" valign="top"><font face="Arial" style="font-size: 18px; " color="#808080"> Claim ID:</font><font face="Arial" style="font-size: 18px; color: black; cursor: pointer" class="transferclaimid_an">12345678999&nbsp;<span style="position: relative; padding-bottom: 5px"> <span title="Transfer" id="bcd" class="fas fa-external-link-alt dropdown-toggle transferclaimid" data-toggle="dropdown" aria-hidden="true" style="cursor: pointer; color: #337ab7; font-size: 14px; top: -3px"> </span> <ul class="dropdown-menu dropdown-menu-right" role="menu" style="left: 10px !important; top: 25px; width: 270px; font-size: 14px !important"> <li><a style="color: #000" href="">Encounter Hospital Processing</a></li> <li><a style="color: #000" href="">Medical Agreement Configurator </a></li> <li><a style="color: #000" href="">FSA Claims Processing</a></li> <li><a style="color: #000" href="">Hospital Claims Processing</a></li> <li><a style="color: #000" href="">Medical Claims Processing</a></li> <li><a style="color: #000" href="">Hospital Claims Logging / History</a></li> <li><a style="color: #000" href="">Hospital Claims Pre-Pricing</a></li> <li><a style="color: #000" href="">Medical Claims Logging / History</a></li> <li><a style="color: #000" href="">Medical Claims Pre-Pricing</a></li> <li><a style="color: #000" href="">Member and Fam Accums </a></li> <li><a style="color: #000" href="">Payment </a></li> <li><a style="color: #000" href="">Dental Claims Processing</a></li> <li><a style="color: #000" href="">Agreement, Medical</a></li> <li><a style="color: #000" href="">Agreement, Dental</a></li> <li><a style="color: #000" href="">Modifier Pricing Rules</a></li> </ul> </span> </font></td> <td width="26">&nbsp;</td> <td valign="top"><font face="Arial" style="font-size: 18px" color="#808080"> ITS Serial#(SCCF)</font><font face="Arial" style="font-size: 18px; " color="#808080">: </font><font face="Arial" style="font-size: 18px; color: black">61120163411000000</font> <a href="#provider_info" data-toggle="popover" data-trigger="focus" data-placement="bottom" data-popover-content="#SCCF" data-original-title="" title=""><i class="fa fa-info-circle" title="Click to see more info" style="font-size: 16px;"></i></a> <div id="SCCF" class="hidden"> <div class="popover-body"> <div style="width: 350px; padding-left: 0px; padding-right: 0px"> <div class="container-fluid"> <div class="row" style="padding-left: 0px; padding-right: 0px; border-bottom: solid 1px #dadada; padding-bottom: 10px; padding-top: 5px"> <div class="col-sm-11 text-center" style="padding-left: 0px; padding-right: 0px"> <span style="font-weight: 400"><strong>ITS Serial Number (SCCF)</strong></span> </div> <div class="col-sm-1" style="padding-right: 0px"> <a href="#member"><i class="fa fa-times-circle" title="Close" style="font-size: 18px; cursor: hand !important; float: right"></i></a> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 400; float: left; color: #808080">Cross Reference SCCF</span> </div> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 500; float: left">61120173251000700</span> </div> </div> </div> </div> </div> </div></td> <td>&nbsp;</td> <td width="27">&nbsp;</td> <td valign="top"><font face="Arial" style="font-size: 18px" color="#808080"> Charges</font><font face="Arial" style="font-size: 18px; " color="#808080">:</font><font face="Arial" style="font-size: 18px; color: black"> $421.00</font></td> <td>&nbsp;</td> <td width="33">&nbsp;</td> <td valign="top"><font face="Arial" style="font-size: 18px" color="#808080"> Paid Amount</font><font face="Arial" style="font-size: 18px; " color="#808080">:</font><font face="Arial" style="font-size: 18px; color: black"> $300.00</font></td> </tr> </tbody></table> <table border="0" cellpadding="0" cellspacing="0"> <tbody> <tr> <td colspan="7" height="10"></td> </tr> <tr> <td valign="top"><table border="0" cellpadding="0" cellspacing="0" style="float: left"> <tbody> <tr> <td valign="top"><span style="line-height: 175%; font-size: 14px"><font color="#808080">Status: </font>01 - Accepted; Awaiting batch</span></td> <td>&nbsp;</td> <td valign="top"><a href="#status_info" data-toggle="popover" data-trigger="focus" data-placement="bottom" data-popover-content="#status" data-original-title="" title=""><i class="fa fa-info-circle" title="Click to see more info" style="font-size: 16px;"></i></a> <div id="status" class="hidden"> <div class="popover-body"> <table border="0" cellspacing="0" cellpadding="0" style="float: left"> <tbody><tr> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td align="right" valign="top"><a href="#status"><i class="fa fa-times-circle" title="Close" style="font-size: 16px; cursor: hand !important"></i></a></td> </tr> <tr> <td colspan="10" valign="top" align="center"><strong> <font size="2">Status Details</font></strong><font size="2"> </font> <hr style="margin: 5px !important"></td> </tr> <tr> <td width="10" valign="top">&nbsp;</td> <td valign="top"><b><font size="2"> Status</font></b></td> <td width="10" valign="top">&nbsp;</td> <td valign="top"><b><font size="2">Date</font></b></td> <td width="10" valign="top">&nbsp;</td> <td valign="top"><b><font size="2">User</font></b></td> <td width="10" valign="top">&nbsp;</td> <td valign="top"><font size="2"><b> Routed To</b></font></td> <td width="10" valign="top">&nbsp;</td> <td valign="top"><font size="2"><b>Reason</b></font></td> </tr> <tr> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">01</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2"> 02/09/2018 09:35:22.367</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">vmallava</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">--</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">--</font></td> </tr> <tr> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">11</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2"> 02/08/2018 15:44:30.820</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">vmallava</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">--</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">Claim return</font></td> </tr> <tr> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> </tr> </tbody></table> </div> </div></td> </tr> </tbody> </table></td> <td width="20">&nbsp;</td> <td valign="top"><table border="0" cellspacing="0" cellpadding="0" style="float: left"> <tbody> <tr> <td nowrap="" valign="top"><span style="line-height: 175%; font-size: 10pt"><font color="#808080">ITS Status:</font></span></td> <td>&nbsp;</td> <td nowrap=""><font size="2">02 - Awaiting SF Creation </font> <a href="#provider_info" data-toggle="popover" data-trigger="focus" data-placement="bottom" data-popover-content="#itsstatus" data-original-title="" title=""><i class="fa fa-info-circle" title="Click to see more info" style="font-size: 16px;"></i></a> <div id="itsstatus" class="hidden"> <div class="popover-body"> <div style="width: 600px; padding-left: 0px; padding-right: 0px"> <div class="container-fluid"> <div class="row" style="padding-left: 0px; padding-right: 0px; border-bottom: solid 1px #dadada; padding-bottom: 10px; padding-top: 5px"> <div class="col-sm-11 text-center" style="padding-left: 0px; padding-right: 0px"> <span style="font-weight: 400"><strong>ITS Status Details</strong></span> </div> <div class="col-sm-1" style="padding-right: 0px"> <a href="#member"><i class="fa fa-times-circle" title="Close" style="font-size: 18px; cursor: hand !important; float: right"></i></a> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-2" style="padding-left: 0px"> <span style="font-weight: 400; float: left"><strong>Status</strong></span> </div> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left"><strong>Date</strong></span> </div> <div class="col-sm-2" style="padding-left: 0px"> <span style="font-weight: 400; float: left"><strong>User</strong></span> </div> <div class="col-sm-2" style="padding-left: 0px"> <span style="font-weight: 400; float: left"><strong>Routed to</strong></span> </div> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left"><strong>Reason</strong></span> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-2" style="padding-left: 0px"> <span style="font-weight: 400; float: left">02</span> </div> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left">02/09/2018. 09:35:29.170 </span> </div> <div class="col-sm-2" style="padding-left: 0px"> <span style="font-weight: 400; float: left">John, Kim</span> </div> <div class="col-sm-2" style="padding-left: 0px"> <span style="font-weight: 400; float: left">--</span> </div> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left">Lorem Ipsum</span> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-2" style="padding-left: 0px"> <span style="font-weight: 400; float: left">02</span> </div> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left">02/09/2018. 07:34:43.110 </span> </div> <div class="col-sm-2" style="padding-left: 0px"> <span style="font-weight: 400; float: left">John, Joe</span> </div> <div class="col-sm-2" style="padding-left: 0px"> <span style="font-weight: 400; float: left">--</span> </div> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left">Lorem Ipsum</span> </div> </div> </div> <!--<table border="0" cellspacing="0" cellpadding="0"> <tbody> <tr> <td valign="top" style="color: #000000"><b><font size="2"> <span style="font-weight: 400; float: left"><strong>Claim Level Overrides</strong></span></font></b></td> <td valign="top">&nbsp;</td> <td valign="top" style="width: 100px">&nbsp;</td> <td valign="top" style="color: #808080">&nbsp;</td> <td valign="top">&nbsp;</td> <td align="right" valign="top"><a href="#member"><i class="fa fa-times-circle" title="Close" style="font-size: 16px; cursor: hand !important"></i></a></td> </tr> </tbody> </table> --> </div> </div> </div></td> </tr> </tbody> </table></td> <td width="20" valign="top">&nbsp;</td> <td valign="top"><table border="0" cellspacing="0" cellpadding="0" style="float: left"> <tbody> <tr> <td nowrap="" valign="top"><span style="line-height: 175%; font-size: 10pt"><font color="#808080">ITS Adjustment:</font></span></td> <td>&nbsp;</td> <td nowrap=""><font size="2">Yes </font> <a href="#provider_info" data-toggle="popover" data-trigger="focus" data-placement="bottom" data-popover-content="#itsadjust" data-original-title="" title=""><i class="fa fa-info-circle" title="Click to see more info" style="font-size: 16px;"></i></a> <div id="itsadjust" class="hidden"> <div class="popover-body"> <div style="width: 450px; padding-left: 0px; padding-right: 0px"> <div class="container-fluid"> <div class="row" style="padding-left: 0px; padding-right: 0px; border-bottom: solid 1px #dadada; padding-bottom: 10px; padding-top: 5px"> <div class="col-sm-11 text-center" style="padding-left: 0px; padding-right: 0px"> <span style="font-weight: 400"><strong>ITS Adjustment Info</strong></span> </div> <div class="col-sm-1" style="padding-right: 0px"> <a href="#member"><i class="fa fa-times-circle" title="Close" style="font-size: 18px; cursor: hand !important; float: right"></i></a> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 400; float: left; color: #808080">Adj. Claim Receipt Date</span> </div> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 500; float: left">01/01/2019</span> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 400; float: left; color: #808080">Adjustment Reason</span> </div> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 500; float: left">285 - Provider Appeal</span> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 400; float: left; color: #808080">Adjustment SF</span> </div> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 500; float: left">No</span> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 400; float: left; color: #808080">SLA Indicator</span> </div> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 500; float: left">Y - Streamline Adjustment Processing Applies to this DF</span> </div> </div> </div> <!--<table border="0" cellspacing="0" cellpadding="0"> <tbody> <tr> <td valign="top" style="color: #000000"><b><font size="2"> <span style="font-weight: 400; float: left"><strong>Claim Level Overrides</strong></span></font></b></td> <td valign="top">&nbsp;</td> <td valign="top" style="width: 100px">&nbsp;</td> <td valign="top" style="color: #808080">&nbsp;</td> <td valign="top">&nbsp;</td> <td align="right" valign="top"><a href="#member"><i class="fa fa-times-circle" title="Close" style="font-size: 16px; cursor: hand !important"></i></a></td> </tr> </tbody> </table> --> </div> </div> </div></td> </tr> </tbody> </table></td> <td width="20" valign="top">&nbsp;</td> <td valign="top"><table border="0" cellspacing="0" cellpadding="0" style="float: left"> <tbody> <tr> <td nowrap="" valign="top"><span style="line-height: 175%; font-size: 10pt"><font color="#808080">Claim Level Overrides:</font></span></td> <td>&nbsp;</td> <td nowrap=""><font size="2">Yes </font> <a href="#provider_info" data-toggle="popover" data-trigger="focus" data-placement="bottom" data-popover-content="#provider" data-original-title="" title=""><i class="fa fa-info-circle" title="Click to see more info" style="font-size: 16px;"></i></a> <div id="provider" class="hidden"> <div class="popover-body"> <div style="width: 450px; padding-left: 0px; padding-right: 0px"> <div class="container-fluid"> <div class="row" style="padding-left: 0px; padding-right: 0px; border-bottom: solid 1px #dadada; padding-bottom: 10px; padding-top: 5px"> <div class="col-sm-11 text-center" style="padding-left: 0px; padding-right: 0px"> <span style="font-weight: 400"><strong>Claim Level Overrides</strong></span> </div> <div class="col-sm-1" style="padding-right: 0px"> <a href="#member"><i class="fa fa-times-circle" title="Close" style="font-size: 18px; cursor: hand !important; float: right"></i></a> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left"><strong>Type</strong></span> </div> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left"><strong>Value</strong></span> </div> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 400; float: left"><strong>Description</strong></span> </div> </div> <div class="row" style="padding-left: 0px; padding-right: 0px; padding-top: 10px"> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left">Pricing Method</span> </div> <div class="col-sm-3" style="padding-left: 0px"> <span style="font-weight: 400; float: left">01</span> </div> <div class="col-sm-6" style="padding-left: 0px"> <span style="font-weight: 400; float: left">ITS Pricing Method Override</span> </div> </div> </div> <!--<table border="0" cellspacing="0" cellpadding="0"> <tbody> <tr> <td valign="top" style="color: #000000"><b><font size="2"> <span style="font-weight: 400; float: left"><strong>Claim Level Overrides</strong></span></font></b></td> <td valign="top">&nbsp;</td> <td valign="top" style="width: 100px">&nbsp;</td> <td valign="top" style="color: #808080">&nbsp;</td> <td valign="top">&nbsp;</td> <td align="right" valign="top"><a href="#member"><i class="fa fa-times-circle" title="Close" style="font-size: 16px; cursor: hand !important"></i></a></td> </tr> </tbody> </table> --> </div> </div> </div></td> </tr> </tbody> </table></td> <td width="20">&nbsp;</td> <td valign="top"><table width="100%" border="0" cellspacing="0" cellpadding="0"> <tbody> <tr> <td nowrap="" valign="top" style="line-height: 175%; font-size: 10pt"><font size="2" color="#808080">Quick View:</font></td> <td>&nbsp;</td> <td valign="top" style="line-height: 175%; font-size: 10pt"><span title="Click to Quick View Attachments"> <a href="#attach_info" data-toggle="popover" data-trigger="focus" data-placement="bottom" data-popover-content="#attachments" data-original-title="">Attachments</a></span>, <span title="Click to Quick View Memo"><a href="#memo_info" data-toggle="popover" data-trigger="focus" data-placement="bottom" data-popover-content="#memo" data-original-title=""> Memo</a></span>, <span style="font-size: 14px"> <div id="memo" class="hidden"> <div class="popover-body"> <table border="0" cellspacing="0" cellpadding="0" style="float: left; font-size: 12px; width: 300px"> <tbody> <tr> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top" align="right"><a href="#"><i class="fa fa-times-circle" title="Close" style="font-size: 16px; cursor: hand !important"></i></a></td> </tr> <tr> <td colspan="7" valign="top" align="center"><span style="line-height: 175%; font-size: 14px" title=""><strong> <font size="2"> Memo</font></strong><font size="2"> </font></span> <hr style="margin: 5px !important"></td> </tr> <tr> <td colspan="7" valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2"> This is a just Memo. This is a Memo. This is just a Memo. This is a Memo. </font></span></td> </tr> <tr> <td colspan="7" valign="top">&nbsp;</td> </tr> </tbody> </table> </div> </div> <div id="attachments" class="hidden"> <div class="popover-body"> <table border="0" cellspacing="0" cellpadding="0" style="float: left; font-size: 12px; width: 550px"> <tbody> <tr> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top" align="right"><a href="#"><i class="fa fa-times-circle" title="Close" style="font-size: 16px; cursor: hand !important"></i></a></td> </tr> <tr> <td colspan="7" valign="top" align="center"><span style="line-height: 175%; font-size: 14px" title=""><strong> <font size="2">Attachments</font></strong><font size="2"> </font></span> <hr style="margin: 5px !important"></td> </tr> <tr> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><strong><font size="2">Style</font></strong></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><strong><font size="2">Description</font></strong></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><strong><font size="2">Updated On</font></strong></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><strong><font size="2">Updated By</font></strong></span></td> </tr> <tr> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">Claim User-Entity</font></span></td> <td width="10" valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">Member Address</font></span></td> <td width="10" valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">10/18/2018 08:59:123</font></span></td> <td width="10" valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">FACETS</font></span></td> </tr> <tr> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">Claim User-Entity</font></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">Provider Address</font></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">10/18/2018 08:22:456</font></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">FACETS</font></span></td> </tr> <tr> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">Contact</font></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">Claim Contacts</font></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">11/26/2018 14:52:220</font></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">FACETS</font></span></td> </tr> <tr> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">User Fields</font></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">User Defined Fields Description</font></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">10/18/2018 08:02:005</font></span></td> <td valign="top">&nbsp;</td> <td valign="top"><span style="line-height: 175%; font-size: 14px" title=""><font size="2">FACETS</font></span></td> </tr> <tr> <td valign="top" height="21" style="color: #808080" colspan="7" align="center"><hr style="margin: 5px !important"> <span style="line-height: 175%; font-size: 14px" title=""><a href="attachments_compact.html#anchor"><font size="2">View Attachments → </font></a></span></td> </tr> <tr> <td colspan="7" valign="top">&nbsp;</td> </tr> </tbody> </table> </div> </div> <span style="line-height: 175%; " title=""><span title="Click to Quick View Notes"><a href="#notes_info" data-toggle="popover" data-trigger="focus" data-placement="bottom" data-popover-content="#notes" data-original-title=""> <font size="2">Notes</font></a></span><font size="2">, </font></span> <span style="font-size: 14px; line-height:175%" title=""> <div id="notes" class="hidden"> <div class="popover-body"> <table border="0" cellspacing="0" cellpadding="0" style="float: left; font-size: 12px; width: 500px"> <tbody> <tr> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top" align="right"><a href="#"><i class="fa fa-times-circle" title="Close" style="font-size: 16px; cursor: hand !important"></i></a></td> </tr> <tr> <td colspan="7" valign="top" align="center"><span style="line-height: 175%; font-size: 14px" title=""><strong> <font size="2">Notes</font></strong><font size="2"> </font></span> <hr style="margin: 5px !important"></td> </tr> <tr> <td valign="top"><strong><font size="2">Style</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2">Description</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2">Updated On</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2">Updated By</font></strong></td> </tr> <tr> <td valign="top"><font size="2">Application Notes</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">Claim Processing Notes</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">10/20/2018 08:59:123</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">FACETS</font></td> </tr> <tr> <td valign="top"><font size="2">Claim Notes</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">Claim Notes</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">10/20/2018 08:28:558</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">FACETS</font></td> </tr> <tr> <td valign="top" height="21" style="color: #808080" colspan="7" align="center"><hr style="margin: 5px !important"> <span style="line-height: 175%; font-size: 14px" title=""><a href="notes_compact.html"><font size="2">View Notes → </font></a></span></td> </tr> <tr> <td colspan="7" valign="top">&nbsp;</td> </tr> </tbody> </table> </div> </div> <span title="Click to Quick View Workflow" style="line-height: 175%"><a href="#notes_info" data-toggle="popover" data-trigger="focus" data-placement="bottom" data-popover-content="#workflow" data-original-title=""> <font size="2">Workflow</font></a></span></span></span></td> </tr> </tbody> </table> <div id="status" class="hidden"> <div class="popover-body"> <table border="0" cellspacing="0" cellpadding="0" style="float: left; font-size: 12px;"> <tbody> <tr> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top" align="right"><a href="#"><i class="fa fa-times-circle" title="Close" style="font-size: 16px; cursor: hand !important"></i></a></td> </tr> <tr> <td colspan="7" valign="top" align="center"><strong> <font size="2">Notes</font></strong><font size="2"> </font> <hr style="margin: 5px !important"></td> </tr> <tr> <td valign="top"><strong><font size="2">Style</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2">Description</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2">Updated On</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2">Updated By</font></strong></td> </tr> <tr> <td valign="top"><font size="2">Application Notes</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">Claim Processing Notes</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">10/20/2018 08:59:123</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">FACETS</font></td> </tr> <tr> <td valign="top"><font size="2">Claim Notes</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">Claim Notes</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">10/20/2018 08:28:558</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">FACETS</font></td> </tr> <tr> <td valign="top" height="21" style="color: #808080" colspan="7" align="center"><hr style="margin: 5px !important"> <a href="appendix_compact.html#anchor"><font size="2">View Notes → </font></a></td> </tr> <tr> <td colspan="7" valign="top">&nbsp;</td> </tr> </tbody> </table> </div> </div> <div id="workflow" class="hidden"> <div class="popover-body"> <table border="0" cellspacing="0" cellpadding="0" style="float: left; font-size: 12px;" width="450"> <tbody> <tr> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top" align="right">&nbsp;</td> <td valign="top" align="right">&nbsp;</td> <td valign="top" align="right">&nbsp;</td> <td valign="top" align="right">&nbsp;</td> <td valign="top" align="right">&nbsp;</td> <td valign="top" align="right"> </td><td valign="top" align="right"><a href="#"><i class="fa fa-times-circle" title="Close" style="font-size: 16px; cursor: hand !important"></i></a></td> </tr> <tr> <td colspan="13" valign="top" align="center"><strong><font size="2">Workflow</font></strong><font size="2"> </font> <hr style="margin: 5px !important"></td> </tr> <tr> <td valign="top"><strong><font size="2"> Routed</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2">By</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2"> Comment</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2"> Queue</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2"> Role</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2"> Picked Up</font></strong></td> <td valign="top">&nbsp;</td> <td valign="top"><strong><font size="2">By</font></strong></td> </tr> <tr> <td valign="top"><font size="2">12/01/2018</font></td> <td valign="top">&nbsp;</td> <td valign="top"><font size="2">Facets</font></td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> <td valign="top">&nbsp;</td> </tr> <tr> <td colspan="13" valign="top" align="center"><hr style="margin: 5px !important"> <a style="cursor: pointer"><font size="2">View Workflow → </font></a></td> </tr> <tr> <td colspan="13" valign="top">&nbsp;</td> </tr> </tbody> </table> </div> </div></td> </tr> </tbody> </table></td> <td align="right"><div class="topright" style="padding-top:5px; 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