TYLER PB
What is the payer indicator on Relay?
Tells if the claim went to primary, secondary or tertiary
What is an adjustment code for SG stand for?
System Generated
Where can you find the complete list of patient's account in EPIC?
Guarantor Summary
If a claim has a status of created and has red exclamation next to it in the liability bucket, the claim has....
Hit a billing edit in Epic
What codes on a remittance file explain why the claim was denied?
Reason/Remark codes
What FL is prior auth number in?
FL 23
How long after the last insurance transaction can a patient be billled?
within one year from denial date
From where can you download a claim status tracking report?
In Epic, what is the most effective way to print multiple medical records at once?
Epic > HIM > Releases > New Releases
Adjustments in the what monetary range need to be approved by Ensemble leadership?
$1,000-$25,000
How can you view verified request in EIQ
Under Action Logs, unclick the hide verified request box
What does EDM stand for?
Electronic Document Management
If a claim denied due to the diagnosis it is sent back to the clinical department for review; if they response to the inquiry that the coding is correct, what is your next step?
Submit an appeal
Once a claim has passed through Epic's scrubber, it then goes where?
Claim Source
Yes or No: The contractual adjustment on the account $32,615.12, but should be only $25,463.17. Should the original contractual adjustment be reversed?
No
What does type of claim show you in FL on Relay?
Type of Payer
What is the effective date of the NEBO to SSI transition?
10/01/2018
What are the correct TOBs for the first, middle, and last claim of a series bills?
First:
Middle:
Last:
First: 132 or 112
Middle: 133 or 113
Last: 134 or 114
Scenario: The claim denies for missing/invalid modifier. The claim was reviewed and updated by coding, bu not resubmitted to the payer. What is the next appropriate action?
Update TOB to XX7 and resubmit via Epic
True or False: The only time you use the initiate billing function is when billing the primary insurance
True
If your txn is missing from under the claims tab, where should you look to find your txn?
view txn or episodes
Where can you locate attending provider taxonomy in SSI?
Additional physician
If late charges are added to a claim, the claim must net at least an additional $__ in reimbursement otherwise it will not be sent out and should be adjusted off.
$200.00
How long after the last insurance transaction can a patient be billed?
6 months
True or False: Charge review requests for inpatient claims are sent to cost center
False