What box would the rendering provider place their taxonomy in on a CMS 1500?
24j
100
Professional claims must be submitted with the rendering and billing providers_______ number?
Taxonomy number
100
(True/False) A Claim Dispute must be submitted before a Claims Reconsideration?
FALSE
100
If a check remitted to a provider was a paper check the check number will always begin with __?
0100
200
If a provider collects payment from a member that exceeds the amount owed after claim adjudication how long does the provider have to reimburse the member?
45 DAYS
200
How long does a provider in the Coordinated Care network have to submit a dispute after receiving an EOP before they are denied for being past timely filing?
24 MONTHS
200
If a check remitted to a provider was electronic the check number will begin with ____?
0109
200
What is the first step of claim adjudication?
FIELD EDITS
200
What system would you use to verify provider status of in network or out of network?
PORTICO OR CRM
300
TOB mean?
type of bill for hospital claims
300
When the provider fails to obtain an __________ and the claim is denied by Ambetter, the provider cannot bill the member.
AUTHORIZATION
300
(True/False)If you as a Member Services Claims Agent receive a call from a Provider, you should handle the call.
FALSE
300
Laboratory claims must be submitted with the facility’s ____?
CLIA NUMBER
300
If a provider calls to request a copy of a paper check, what website would you recommend to them to enroll in Payspan?