Services
What is an authorization and who is responsible for obtaining the authorization?
Prior-Authorizations (aka preauthorization’s) is the process of getting an agreement from the payer to cover specific services before the service is performed.
The providers office must obtain the authorization prior to services being rendered
Who painted the Mona Lisa?
Leonardo da Vinci
Provide the Q-Filter Formula to search the following:
?TPX=99214
?TC=123456
?S=04/17/2025
When a claim is denied for COB, what does this mean?
This denial is when an insurance policy denies a claim as the patient has multiple insurance policies on file and there is confusion about which is primary and which is secondary, leading to incorrect billing.
What is Aprils Birthstone?
Diamond
Samantha goes to the hospital for abdominal pain and is admitted for one week when it is discovered she has appendicitis. Which place of service would this be considered/billed under?
Inpatient
When Did Facebook Launch?
2004
Please identify where the insurance should be updated based on the below visit numbers:
SF = Soarian
LH = Gecb
True or False:
A claim is denied for eligibility, and you are unable to locate active primary insurance, so we would submit medical records with a generic letter to send as support for the charges.
False –
We should be trying to locate the patient's active insurance by searching AHER/Soarian/Facility Notes/ GECB Visit Lists and at times a phone call to the patient is required.
What tree signifies Spring? They bloom in Washington, DC in the spring
Cherry Blossoms
List 3 changes that should be performed as a Phase 1 Charge correction
When is “National Ice Cream” month?
July
List 2 ways to locate facility MRNs
Preview Pane – Registration other numbers
Patients hyperlink name, scroll to “other numbers”
A claim could be denied for missing a referral on file. What kind of insurance plans would require a referral to be obtained?
HMO & POS
This spreads through the air from flowers & trees which causes spring allergies?
Pollen
How do you very the place of service in an Invision system?
The “PT NO” can be used to verify place of service
1 = ER
2 = Private Ambulatory
3 = Clinic
4 = Therapy-Employee Health Services
5 = Inpatient
6 = Ambulatory Surgery
7 = 2 Levitt Endoscopy
8 = Dialysis-Nursing Home Patient
**Forest Hills ER (Forest hills ER uses 1 & 8)**
9 = Pre-Surgical Testing
Who was the first televised President?
Franklin D. Roosevelt
What dictionary allows you to see the providers information?
Dictionary 100
This denial happens when a service is included to another billed service on the same date
Bundling
What city is known for its stunning tulip gardens?
Amsterdam, Netherlands
What is force extraction and what is it used for?
Force extraction means coding already reviewed the records and determined there are no changes to be made based on the notes.
If a CPT has not been force extracted, you can escalate to coding
What is the national sport of Canada?
Lacrosse
When you are reviewing an invoice, and see “NOCHECK1230406CORRPMP” listed in GECB, what does this mean?
There is a correspondence/EOB/Remit posted in TD Bank
If a patient has a procedure to have their appendix removed, however the doctor billed a diagnosis of Migraines, what denial will this cause?
CPT/DX Mismatch
What is the name of a group of butterflies called?
Kaleidoscope