Health Information Portability and Accountability Act
100
Name any payer that typically disallows charges upon review of high dollar claims.
Blue Shield, Blue Cross, or Health Net
100
This team member's favorite sports team is the San Jose Sharks and he/she can often be found as a supporting parents on the sidelines of junior league hockey games. Do you know who this team member might be?
Shawn Tienken
100
What method is used to determine when a plan is primary or secondary for a dependent child when covered by both parents' benefit plan?
Birthday Rule
100
What are the 5 nutrition food groups launched by the USDA in 2011, that when combined in moderation can lead to healthy living?
In what year did PFS move from the building in Hanover to Bohannon?
2011
200
If we are submitting a corrected claim to Blue Shield, what is our technical timely filing limit?
Billing limit of 180 days to submit a “clean” claim. Corrected claims should not technically fall under appeal limits (365 days)
200
Which member of our team used to be the lead singer in a band?
Sydney!
200
What limit does the Affordable Care Act prohibit insurance companies from placing on any group or individual as of 9/23/2010?
Lifetime limit caps
200
Name one artificial sweetener that is approved for use in the United States.
Acesulfame K, aspartame, neotame, saccharin, or sucralose
300
What four topics do our AIP goals consist of?
CFB, AR, Denials, Scorecard
300
Based on Feb 2016 numbers, choose from the listed ranges to indicate what CCS HPSM’s average day to first payment is. A) 17 – 22 days B) 24 – 29 days C) 30 days +
B - 26.66 days
300
Which Disney character does Dora associate her husband with?
Donald Duck
300
What does EMTALA stand for and what does it mean when referring to LOA negotiations?
Emergency Medical Treatment and Labor Act, LOAs are not negotiated for EMTALA transfers
300
Studies show that drinking juice from this vegetable will help muscle cramps disappear faster than drinking water or nothing at all. Might be a helpful tip next time you hit the gym!
Pickle juice
400
Without using your badge as reference, what does the “R” and “S” in PCARES stand for?
Respond Promptly and Support the Team
400
At what date range should an account be copied to a Leads’ escalation WQ?
60 days assuming confirmation of bill receipt and follow-up escalation with payer manager/supervisor has already been attempted
400
What is Jack's least favorite type of food?
Veggies
400
What is the general summary of Assembly Bill 1324?
Insurance cannot retroactively rescind or modify previously approved authorization or deny reimbursement based on retroactive cancellation or modification to member’s coverage
400
REM (rapid eye movement) sleep typically happens within this time period after you fall asleep and lasts for about 10 minutes
90 minutes
500
How many characters (numbers and alphas) can an ICD-10 code have?
7
500
As of 3/29/16, how far are we from our fiscal year cash posted to date goal?
$11.5M
500
How many children does Caroline have, and can you name them in descending order by age?