What's the diff?
Contracts vs Provider manual
Contracts: Negotiated, payer-specific reimbursement rates and terms
Provider Manual: Payer’s billing rules, coverage policies, and claim submission requirements.
1- Rev
2- POA
3- DX
4- HCPCS
2-POA is an indicator while all others are called codes
38008546
No Auth
What is the most popular per costume?
a-hotdog
b-pumpkin
c-witch
B
HESMOTR SHAM
Monster Mash
Medicare vs Medicaid
Medicare= Age, disability, esrd
Medicaid= Income
1-DOS
2-DOB
3-D&A
4-Statement date
3-D&A- All other are in ref to dates, not a unit
268052
Untimely Follow Up
What does the word "witch" mean?
a-spell caster
b-moon woman
c-wise woman
VENERUE CYCLE LITPSESAIC
Revenue Cycle Specialist
UB04 vs CM-1500
UB-04: Institutional claims (hospitals and facilities).
CMS-1500: Professional claims (physicians and individual providers).
1-Francesca
2-Larisa
3-Diane K
4-Mary S
1- Fran is not a manager
M27
Fidelis Medicare HMO
Which Celtic festival inspired Halloween?
a-Beltane
b-Samhain
c-Yule
B
TINPAET NANCILAF CEVISERS
Patient Financial Services
Reconsideration vs Appeal
Reconsideration: Request to review a claim payment or denial, often correcting errors or providing additional information.
Appeal: Formal challenge disputing the payer’s decision.
1- Christmas
2- Thanksgiving
3- Halloween
4- New Years
3-Halloween is not a federal holiday
Bill type- hosp/otpt/initial claim
Name the 3 Sanderson sisters.
Winifred, Sarah, and Mary
CENOIL RURMO
Nicole Murro
Standard email vs. Secure email
Standard Email: Regular email; not necessarily encrypted or secure.
Secure Email: Encrypted email used to protect sensitive information, such as PHI.
1- Medicare
2- Tricare
3- Medicaid
4- WTC
3- Medicaid is state, all others are federal
USER
demand function used when adding a 28R
What is the fear of Halloween called?
a-Samhainophobia
b-Nyctophobia
c-Wiccaphobia
A
KRICT RO TAERT
Trick or Treat