Adjustment codes we use
Name the adjustment code for sequestration
What is MS
Where do you specifically find the BLS outsourced amount
What is in the contract amount on recovery screen
Who are you sending adjustment request to
What is the lead and emailing the lead and trainer
What must you do prior to closing an account but after your adjustment request is approved
In the Adjustment template below that was approved, what does UA1 signify
BLS Outsourced Amount= $5284.35
Expected Reimbursement: $5,284.35
Claim Paid = $0
Bridge Adjustment Code= UA1 $5,284.35
What is appeal lost at the first level
Name the adjustment code for contractual
What is CW
What locations can you find the expected reimbursement amount
What is the bls calc box or the reimbursement tab in epic
Name 1 example or situation when you would send for adjustment request
What is when appeals are exhausted, when it is timely, when it’s unworkable, when it’s a one and done
What action code do you use to close an account after putting in adjustment but there was a payment we could claim
What is DPF
In the adjustment template below, what does RCQ signify
What is return to client as requested, for recall process
What adjustment code may be used along with placed in error reason code and may be used to adjust an account due to not being able to work the account
What is PIE/RCQ
How do you check if there are payments on the account in bridge
What is in the recovery screen in the add/ edit button next to the Additional Payment received
What action code are you sending adjustment request in
What action code do you use when you close an account to signify it was adjusted in full
What is DAF
In the Adjustment template below, what are the names of the 2 adjustment codes listed and what do they mean
Outsourced Amount - $1807.77
Expected - $1465.24
Primary Paid - $1229.16
Secondary Paid - $272.67
Adjust MS - $25.09
Adjust CW - $280.85
What is sequestration= MS=
Claim reduction due to 2% Medicare Sequestration
What is Contractual= CW= Contractual Write-off
Where can you locate in bridge recovery screen what adjustment codes to use
What is in the add/ edit button next to the adjustments
Who does the adjustment request get sent to as collector while in training and what action code do you use
What is the lead and Dorr
If your lead sends account back to you in DAA action code what does that mean, what if it’s DAD
What is It’s approved, DAD means it’s denied and rework and send back to them
True or false: you can close an account without adding adjustment codes to Bridge if there is adjustments
What is False
If Requesting adjustment due to all levels are exhausted and you determined the only adjustment would be the appeal was lost at the second level, what would the adjustment code be
What is UA2
On an EOB, where might you look to determine what adjustment is needed
What is under remit codes
What is the adjustment template format and other than sending to the lead, who else are you emailing when requesting approval
Bls outsource
Expected
Paid
Adjustment code
Who is Your trainer
How can you check your DAAs and DADs if you do not get an email back from your lead
What is Pull your name as collector and search for DAA and DAD
What should the final amount due equal to unless there is an overpayment when you have adjusted the account
What is 0
On the EOB, under the remit codes Patient responsibility is listed as $1000. The appeal was lost and now appeals are exhausted at the first level due to a one and done for this client. The contract amount in Bridge listed as $5000, the expected reimbursement was $4000 and the final amount due was $5000. No payments were made. Write out the completed Adjustment template request you would notate in bridge to send
What is:
Outsourced : $5000
Expected : $4000
Claim Paid: $0
Adjust UA1 : $4000
Adjust PT:$1000