Provider Verification
This is the goal of CSR agents when handling provider inquiries.
What is resolve all cases on the first call (or contact)?
Electronic Visit Verification
What does EVV stand for?
This team will help support trading partner account issues.
What is the EDI Help Desk?
This tab in Workspaces verifies the identity of the caller and manages call tickets.
What is the CTMS tab?
32 degrees in Farenheit is this in Celsius.
What is 0?
This is the minimum number of details to verify when a provider calls.
What is 3?
This is where you would go to check procedure code reimbursement
What is the Interactive Fee Schedule?
Minimum number is 15
What is the minimum number of transactions required per test file for certification?
This is NOT a required field when manually verifying a caller in the CTMS screen.
What is a claim number?
Between 1950 and present day, this is the month with the most recorded tornado touchdowns in the United States.
What is May?
This is another name for API.
What is Medicaid Provider ID?
This is a two character code that provides additional info on a service or procedure.
What is a modifier?
This is acknowledgement of receipt
What is the role of the 999 transaction file?
This is the first step when opening a call
What is introduce yourself?
These are the flat, pancake-like clouds that can cover the entire sky, like fog.
What are stratus clouds?
This team handles escalated issues with claim edits that CSRs cannot resolve.
Who are Claims Resolutions Specialists?
The EFT setup
What should you check first when investigating a missing EFT?
Providers will need to correct and resubmit the file
What should be done if a test file fails validation?
Verify at least 3 pieces of information
What must CSRs do before releasing any information to a caller who cannot be automatically authenticated?
This is the halo that often forms around the sun when it is low on the horizon.
What is a sun dog?
An example of this would be transferring calls within your skill set without attempting resolution.
What is call avoidance?
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What causes a KICK payment claim to be denied?
Managing multiple insurance coverages for a beneficiary.
What is Coordination of Benefits(COB)?
This tab allows CSRs to view beneficiary’s Medicare Part A & B eligibility?
What is the beneficiary info tab?
This country is the lightning capital of the world.
What is Venezuela?