Reject Codes
Reject 11 means
What is “other insurance is primary”
Provide the meaning and definition of DOD
What is date of denial - the date the claim was denied
This is the WBS screen you go to in order to perform a BTT
What is transfer
These two things must be in the subject of an email
What is the entity and invoice number
What is PEGA
This reject means “primary insurance through auto, liability or other insurance”
What is reject 56
Bill type 3 means
What is Medicare insurance
This WBS screen is where to go to look at all claims for the patient you are reviewing
What is other bills
True or False: Notes should tell a story
What is True
Name 2 things FLINT helps you find
What is 3PFs and code lists
Out of reject 21 and 24, this one bills the patient
What is Reject 21
The requisition is
What is the order form that includes test and patient information
The bill cycle shows you
What is the history of a bill
This is the email address we send for the domestic team to review the invoice further
What is OPRO 3P
Provide the steps to verify insurance in RTE
1. Input bill number and press “load from ARBRR”
2. Select payer name
3. Click submit and look for info on right
This reject means we are looking for Medicare as the primary insurance
What is Reject 10
Provide the meaning and definition of DOS
What is date of service - the calendar date the specimen was collected
True or False: It is okay to make the following name change without verification:
Ken to Ben
What is False
When sending an email to the OPRO 3P mailbox, this should be included in the body of the email
What is the explanation of issue and screenshots
This website is used to do an MBI lookup for a Medicare patient
What is WPS
This reject means we are looking for a different insurance then the one we have because the insurance we have is not active
What is Reject 16
This bill type means Medicaid insurance
What is bill type 4
BCBS requires we do this when sending any claim
What is send to state referring physician is registered in
While researching the claim, you find all information we have is correct and the insurance is active but a Reject 21 was received. Provide what you would do
What is email the OPRO 3P mailbox with an explanation and screenshot. Close in PEGA as emailed OPRO 3P mailbox
Name two of the eligibility sites we have used
What is RTE, WPS, Tevix, Eligibility 5.0 and Onesource