True or False, If the provider is using their SSN, the prefix that we assign them is 1.
True
100
This form was originally developed by Health Care Finance Administration (HCFA) and is used for billing Professional services.
CMS 1500
100
You must include this in your call opening along with your name.
Resolution Specialist
100
Which SOP should we use in looking up Scopic procedure information?
Provider Scopic Procedure SOP
100
How many digits are there in a CPT code?
5
200
List down the four major categories of a provider.
1. Individual
2. Group
3. Facility
4. Other
200
It is a non standard form used by a provider to provide information on the insured when submitting claims.
Superbill
200
This deductible includes a family and individual deductible, which is usually half or one-third of the family deductible.
Embedded Deductible
200
Which SOP should we use in looking up information with regard to Diagnostic Services?
Diagnostic Services SOP
200
What is the CPT code range for E/M Services?
99201 - 99499
300
List down the steps in checking the provider's specialty in ISET.
PROVIDERS > SEARCH AND DETAIL > DETAILS
300
What is the CPT code range for Radiology Services?
70010 - 79999
300
What are the 3 search types in IBAAG
1. All bookmarks
2. Sectional bookmarks
3. Ctrl + F
300
What SOP can you use to help you in looking up a provider and matching their contracts in ISET.
Provider Lookup and Contract Matching SOP.
300
This form is used to submit claims for the facility.
UB04 Form.
400
What are the three UHPD indicators and their meaning?
Q - Quality
E - Efficiency
Q&E - Quality and Efficiency
400
CPT codes are created by who?
American Medical Association
400
When no INN providers are available within a 30 mile radius of the member’s home ZIP code, an exception to allow INN benefits for services provided by an OON provider.
Network Gap Exception
400
Which Job Aid are you going to use if you need information with regards to the products that we offer.
UnitedHealthcare Products Job Aid
400
These codes are exclusively used by the facility and describes the type of service and supplies that the patient received in the facility.
Revenue Codes
500
This is a program that can help our members locate the best of the best from our current network of outstanding physicians, and facilities.
UnitedHealth PremiumSM Designation (UHPD)
500
When is the current deadline for the implementation of ICD-10?
October 1, 2015
500
What type of Medicare complementary plan would cover part A and part B deductible in full?
Med 4
500
This Job aid will help you with the different transaction codes in UNET
UNET TOPS Transaction Code and Control Line Quick Reference Guide
500
True or False, A HCPCS code is 5 digits, alpha numeric with the letter being placed after the four numeric characters.