Processing
Addnt Processing
AUTHORIZATIONS
TOB
MISCELLANEOUS
100

YOU HAVE A PAPER CLAIM 

WHAT IS REVIEW DCN IN DOCDNA?

100

YOU GET AN AUDIT FOR INCORRECT EVENT CODE.

WHAT IS BACKOUT CLAIM AND CORRECT EVENT CODE?

100

NOTES STATE CONTRACTUAL DENIAL PER EVICORE.

WHAT IS DENY MSI?

100

YOU HAVE A TOB 117 IN HISTORY AND YOUR PENDED CLAIM IS A 111

WHAT is Deny DPC?

100

What Disney Princess has a tattoo?


Pocahontas 200

200

YOU HAVE AN mEV EDIT AND THE PROVIDER SPECIALTIES ARE NOT THE SAME. FOR EXAMPLE ONE IS AN ENDOCRINOLOGIST AND THE OTHER IS A CARDIOLOGIST.  

WHAT IS APPLY CE OVERRIDE AND NOTATE. DO NOT CONTINUE WITH THE EVALUATION AND MANAGEMENT SERVICES SOP.

200

YOU GET AN AUDIT YOU DONT UNDERSTAND.

WHAT IS SEND QUESTION TO NEW DAY BOX AND CC LEAD AND SUP?

200

YOU HAVE AN INPATIENT CLAIM AND THE CLAIM HAS BOTH A DENIED INPATIENT CLAIM AND AN APPROVED OUTPATIENT AUTHORIZATION

WHAT IS ATTACH THE INPATIENT AUTHORIZATION AND PROCESS PER AUTH.

200

You have a TOB XX5

What is deny claim TOB and add mnemonic RWKUPHMM/DD/YYYY [INSERT COMMENT]

200

What does the Earth and a Pizza have in common?


The Crust

300

Claim is received from WEBSTRAT WITH PRICING ATTACHED

WHAT IS check pricing request was sent correctly and verify pricing sheet in DOCNA?

300

YOU NEED TO RETRACT THE CORRECTED CLAIMS LETTER SENT IN ERROR.

WHAT IS ADD THE NOTATION NOTRWKUPHDD/MM/YYYY

300

YOU HAVE AN OUTPATIENT CLAIM WITH AN AUTH THAT STARTS WITH IP

WHAT IS YOU VERIFY THE AUTHORIZATION and SOP?

300

Your claim has a denial of 852 Mue

What is review for possible dup, and MUE SOP.

300

In the state of Georgia, it is illegal to eat what food with a fork.


Fried Chicken

400


YOU NEED TO RETRACT A CORRECTION CLAIMS LETTER SENT IN ERROR

WHAT IS NOTRWKUPHMM/DD/YYYY ENY UBI AND NOTATE?

400

YOU DID NOT MARK THE CLAIM UNCLEAN AND CLAIM IS ALREADY FINALIZED.

WHAT IS ADD A NOTE THAT THE CLAIM IS UNCLEAN?

400

THE CLAIM HAS LINES PENDING AUTH FOR INJECTIONS AND THE AUTH ON FILE HAS NOTES WITH DOSAGE AND FREQUENCY

  

Send to box to have claim routed to SDR.

400

TOB 851 AND THE CONTRACT IS CONFIGURED TO APPLY 43% OF BILLED CHARGES

 WHAT IS PROCESS PER SYSTEM LOAD?

 

400

What is the name of the tallest grass on earth?


Bamboo

500

Claim is pended 603 or QRP

 What is do not hit reprocess, skip claim and send a email to the box.

500

YOU HAVE A PENDED 12X ON FILE, WHAT TOB NEEDS TO BE DENIED IN HISTORY?  

WHAT IS A TOB 111?

500

THE INPATIENT CLAIM HAS AN AUTH ATTACHED AND IS PRICING. 

WHAT IS REVIEW THE AUTH IS FOR INPATIENT AND MATCHES THE BILLING PROVIDER?

500

Q: TOB FOR FQHC


WHAT IS TOB 77X?

500

The Okapi is the cousin to whom?

Giraffe

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