Claim Forms
The name of the two claim forms providers use to bill for services.
What are HCFA & UB
Your briefcase is located..
What is the Enterprise Services tab in ika?
What is Coordination of Benefits?
Name 2 types of codes that describer what procedure a provider performed.
What is CPT, HCPCS, or Revenue Code?
True/False: CSRs can tell a provider how to bill a claim so that it will pay?
What is False?
Ambulance companies use this form to bill.
What is the HCFA 1500?
You need to select this if you need to add notes to an open case.
What is "Add Action"?
Lasso needs ___ in order to process a claim as secondary.
What is an EOB/EOP/Voucher from the primary carrier?
This type of Home Health Agency claim has a TOB 322 and a $0 charge.
What is a RAP claim?
Claims received more than __ months from the date of service will deny for failing to meet timely filing requirements.
What is 12?
Skilled Nursing Facilities use this form to bill.
What is the UB 04?
You must try to reach a member by phone __ times before closing a case via letter.
What is 3?
Subrogation is...
What is the process that allows Lasso to recover expenses for treatment of an illness or injury that another person or organization was found to be legally liable for?
All DME claims require this modifier.
What is KX?
Dr. Smith disagrees with a claim that has denied. You research the claim and find that it has denied correctly. Dr. Smith's only option now is...
What is submit an appeal?
This is the only facility that bills on a HCFA 1500.
What is an Ambulatory Surgical Center (ASC)?
The timeframe to close a Verification of Medical Expense written inquiry is __ days.
What is 7?
The primary carrier for a member who is in hospice care.
What is Original Medicare?
You review the Lab National Coverage Database and the HCPCS/diagnosis code pair billed on the claim is not found. This means that...
What is: the claim will deny correctly?
Electronic checks begin with a __ and paper checks begin with a __.
What is 5 and 4?
CSRs have 2 options to search for claims in ika. One is the "Claims Tab". The other is...
What is "Enterprise Services"?
You must do this in ika with a letter before you close your case.
What is upload the letter to your case?
What is the process by which Lasso will pay claims and if it's determined that another entity should have paid primary, Lasso will pursue reimbursement?
You use this resource to verify if 2 procedure codes that denied as "bundled" can receive separate payment if the provider adds a modifier.
What is the NCCI Edits list? (or PTP Edits link)
This field in ika is how CSRs know if a check has cleared.
What is the "Posted Date"?