BDC
What is the correct reason code to use when accounts are being worked by the AR team
What is 101
If the claim denies with the denial code QMB eligible, what happens to the patient responsibility
What is Adjust to QMB code
What is the guidelines on how often a balance of $1,750 should be reviewed?
What is 21 Days?
What team would review denial CO45 only
Who is the Underpayment Team?
Culturally, the people of Switzerland are known to consume the most of this sweet, cacao-based treat per capita.
What is chocolate?
What is the correct reason code to use when opening a BDC to route to Authorization
What is 197
If the patient has a secondary plan listed and the primary applied $1500 to patient responsibility. Who is responsible for the balance
Who is The Secondary Plan
What is the follow up guidelines on balances less than $1,500
30 Days
Which team would work the denial CO29 - The time limit for filing has expired
Who is The Timely Filing Team?
Often referred to as Earth's "twin planet," it is the second planet from the Sun.
What is Venus?
What is the correct reason code to use when opening a BDC to route to Medical Necessity
What is 50
What percentage is the self-pay discount
What is 65%
At what time is an account considered backlogged
Which team would work the denial CO38 - Services not provided or authorized by designated providers.
Who is the Authorization Team?
In the 1988 movie Mystic Pizza, this future "Pretty Woman" made her major acting debut.
Who is Julia Roberts
What is the correct reason code to use when opening a BDC to route to Timely Filing
What is 29
What is the next step if the denial CO51 - These are non-covered services because this is a pre-existing condition is received
What is Drop to Patient Responsibility?
What should you do if an account was routed for review and it is now due for follow-up and no review has taken place by another department
What is Escalate to Leadership
If we billed DRG 2953 however the plan processed and paid DRG 2943 causing the claim to underpay. Which team would appeal
Who is the DRG team?
In 2015, this team won the Super Bowl in Arizona on February 1st
Who is the New England Patriots?
What is the correct reason code to use when opening a BDC to route to DRG
N199
The patient is 65 years old and is still working for Walmart. The patient has BCBS through Walmart and Medicare A/B. Who would the primary payor be?
What is BlueCross BlueShield?
If you are reviewing an account that has split buckets and you are obtaining a status for both claims, the first claim is showing expected $1,500 and the second claim is showing expected $29,575.39. What is the appropriate follow up timeframe?
What is 14 Days?
Which team would work the denial CO39 - Services denied at the time authorization/pre-certification was requested.
Who is The Medical Necessity Team
This team won the 2010 FIFA World Cup
Who is Spain?