CRM Screens
What are the CRM screens that you will use to retrieve claims information? (2)
Claim summary page
Claim detail page
What can we ask the member to gather information about a claim? (3)
Date of Service
Provider/facility name
Total charge amount
Cual es el animal que tiene todas las vocales en su nombre?
Murcielago.
Cual es el Oceano mas grande del mundo?
Oceano Pacifico
La 4ta estrofa del Himno Nacional
Por tres siglos tus hijos oyeron
el mandato imperioso del amo,
por tres siglos tu inutil reclamo
en la atmosfera azul se perdio.
Pero un dia de gloria tu oido
percibio, poderoso y distante,
que alla lejos, por sobre el atlante
Indignado rugia un leon.
What information can you find on the claim detail page? (3)
DOS
Source
Claim type
Authorization number
Platform
In which cases are we allowed to transfer a call to CRU?
NEVER.
What is the name of the hyperlink located in the Claim Detail page that shows a view on how the claim was submitted?
Claim Image.
Say your greeting:
....
Cual es el pais mas grande y el mas pequeño del mundo?
What is the timeframe for a pended claim to finish processing?
There is no time frame.
What is the formula to get the Allowed amount?
Member responsibility + Paid amount = Allowed.
Cuantos huesos hay en el cuerpo humano?
206
What is a claim?
Notification to an insurance that payment of an amount is due under the terms of the policy.
Cual es la capital de Mongolia?
Ulan Bator
What is the CAS claim prefill link for?
Access the web system and opens the CAS screen MHI.
What are some reasons a claim can be denied? (3)
No authorization on file
Services are not covered
Incorrectly submitted
Missing Information
Cuantos puntos tiene un dado?
21
What are the status of a claim?
Pended
Paid
Denied
Donde se produce la insulina?
En el pancreas.
What info can be found on when the line item is expanded? (2)
Cause Code
Place of treatment
Name scenarios where PaF cannot help? (3)
G&A
Home Health Claims
Skilled Nursing
Cuantos elementos hay en la tabla periodica?
118 elementos.
En que año se hundio el titanic?
1912.
Si el Lobo Aulla, La ballena?
Resopla