Company, ERISA, ARS Docs
What does ERISA stand for and what does it do for ARS?
Employee Retirement Income Security Act; allows the members 2 levels of appeal.
How many units is 22/23 modifier worth?
client specific
How many weeks do we wait before calling on a "Billed" claim?
Three weeks
What three dates must be present within a correspondence note?
Today's date to lead the note, the received date of the corr, and the letter date on the corr.
What kind of H2O does Ely drink?
Aquafina. :)
Which ARS docs are not client specific?
AOB, SA, OON
Which claim form would pointers be utilized on/for?
HCFA
Name 3 pieces of information (any) that must be obtained while on a call.
Rep name
Ref Number
Received date
Processing time
Claim Number
Where and how do you file corr that does not have a DOS present?
On the home page for that patient/facility. Notate the information in the most recent DOS.
What is the name of the 4 brothers?
Sean, Brandon, Greg, Chris
What does ASD stand for and what does it mean/do?
American Surgical Development; fills empty rooms/marketing tool/networks providers&patients.
What is the CMS name for a UBO4? A HCFA?
UB04 = CMS1450
HCFA = CMS1500
Please describe the reprocessing process.
Request reprocessing, next step "Submit 1st Appeal" two weeks out. In two weeks, check corr. If no corr, send the appeal.
When would you place something into the UNKNOWN folder?
When there is nothing on teh corr to idenitfiy who/what/when. We didn't billed the patient, we do not bill for the client, etc.
What are two ways to maximize call production?
Group my carrier, group by patient, read the notes ahead of time, don't be placed on hold.
3 for 1 - What file type does each checklist belong? Physician Checklist, Admin Checklist, FAN Checklist.
Physician checklist is for ASD files. FAN checklist is for ARS files. Admin checklist is for ASD files that utilize an administrative company.
What tab is the "implant cost" supposed to be updated in?
Payment Information tab
2 in 1: What do we set the follow up date out for when the claim form status is "Requested EOB/Payment from Client".
What about "In Process with Carrier"?
Request EOB = 1 week out
In Process = 2 weeks out
What is the Claim Form Status/Next Step you will select when filing an appeal acknowledgment?
Keep the same as the previous note - do not interrupt the process.
If you save the wrong persons' docs in the wrong file. You would submit a ticket via Jira/iiONs.
Name 5 Departments within ARS.
Negotiations, Check Recovery, Legal, QA, Billing, Patient Choice.
What clam do you link the anesthesia claim to within the "secondary Linkage" tab within iiONs?
Professional claim.
What section must be updated within iiONs when receiving payment information on the call? What 1 piece of information must be obtained before updating this?
Pending Payment Information section; Issued Date.
Name 3 common types of correspondence that ARS receives.
Appeal Ack
Appeal Resolution
AOR/Authorization corr
Supporting Docs
Lacking information
How many windows are in this entire room?
14