Insurance
What is the new Suffolk employee insurance plan code now that they are changing over to Aetna?
J48
What does CARC 22 indicate?
COB issue
What is prompt pay? and how long is it?
Prompt pay law requires payment of health claims by health insurance companies within 45 days of receipt of such claim
How do you send a secure email? And when would a secure email be appropriate?
Using brackets and the word secure in your subject line [secure]
What is Nicole's fav drink?
MONSTER!!
What is timely filing for Medicare
1 year from DOS
What is the allowance code used to move $ from insurance to insurance?
506014
Where do we send inpatient accounts that are not authorized?
RTDA
What is the low $ threshold for escalating accounts to RIRV?
$500.00
Who's birthday is on Christmas?
Kelly
What is Aetna's standard reconsideration timeframe?
45 days
What is the difference between a HCPCS code and a REV code?
HCPCS codes identify specific medical procedures, supplies, and services, while revenue codes identify the type of service
Who is the Aetna JOC lead?
Tammi
How long do you need to be in UUP before you are "permanent"
7 years
What is Annie's sons name?
Eloy
ANY OON BX IS ACCEPTABLE
What do JZ and JW modifiers indicate when coded on a claim?
JW modifier indicates that a drug amount was discarded and not administered to any patient, while the JZ modifier indicates that no drug amount was discarded and not administered to any patient.
What unit handles refunds?
Denials and appeals
Name at least 2 things that must be considered when qualifying Medicare coverage
AGE
Retirement
ESRD
HOSPICE
Spouse coverage
COB
etc
Who is celebrating their 1 yr anniversary today?
Josseline
How do we determine COB for a child when that child is enrolled in both parents commercial insurances?
Birthday Rule- define
What process do we use for outpatient coding reviews?
RIRV
What are 3 steps in the process for identifying and working a no auth denial?
ANY 3 correct steps!
What two systems do we use to update an insurance for a patient?
PM Office and RC9U (AKA: envision or UHIS )
What song does Nicole like to get stuck in Angela's head?
Delta dawn :)