9800A Policy can u see?
Under MPC the most we will pay for funeral expenses is?
$3000 or the available limits left under the policy, whichever is less
Per the limits section under MPC the most we will pay funeral expenses is $3000 or the remaining available policy limits, whichever is less.
If you identify a coverage question during your coverage analysis, per the SCP, who should you notify?
"Team Manager"
Per the PIP/MPC SCP Claim Investigation – Coverage Questions Folder, you should send a file note to your team manager.
Hospital bills usually come in on what type of standard form?
UB04
What does BUI stand for?
Bill Under Investigation
Kevin once said.... "State Farm cares, but they do not …."
Cater
Under MPC Coverage, a Group 2 insured has to be ______________ one of the vehicles listed to be considered a Group 2 insured?
Occupying
Per the definition of Group 2 insured, they have to be occupying one of the listed vehicles in order to qualify as a group 2 insured.
If a coverage question involved only the PIP/MPC COL, who should complete the coverage question investigation?
The PIP/MPC Specialist
Per the PIP/MPC SCP Claim Investigation – Coverage Questions Folder, the PIP/MPC Specialist would handle a PIP MPC only coverage question.
True or False?
Expenses we can consider under as funeral expenses are grief counseling, burial plot, casket, and embalming.
False.
Grief counseling is not a type of funeral expense. We only pay charges specifically related to the funeral.
What does AOB stand for?
Assignment of Benefits
What does C.A.A.P.S. stand for ?
In order please.....
Calendar
Auto Pay
Authority
Pending
Subrogation
Per the policy, we are primary for MPC coverage for which of the following vehicles?
"Your Car "
Per the If other Medical Payments Coverage or Similar Vehicle coverage applies section of MPC, we are primary for Your Car and excess for any other vehicle.
Where in the SCP's would a CA find information on how to request Authority outside of the payment process?
Claim Activity and Processing > Authority Requests > Authority Requests Outside Payment Process
What does EOR mean?
Explanation of Benefits
What does PEC stand for?
Pre Existing Condition
Kevin once said that this "thing" is happening even while we sleep...what is that?
AutoPay/Bills
Per the 9800A policy MPC is for treatment obtained within 4 years of the date of the accident, true or false?
False
MPC is for medical services that are provided within 3 years immediately following the date of the accident as long as the insured was first provided treatment within 1 year immediately following the date of the accident.
Where in the SCP would I find how to correctly mail/documents in a claim file?
Claim Activity and Processing>Mail/Document Management
What does CPT, HCPCS, and ICD stand for?
Current Procedural Terminology (CPT)
Healthcare Common Procedure Coding System (HCPCS)
International Statistical Classifications of Diseases (ICD)
What does IBT stand for?
Invoice Bill Tracker
What state did Kevin begin his SF career in?
Florida
If we wanted additional information on the term "struck by" where would we look?
Auto Claim Manual (ACM)
The MPC article in the Auto Claim Manual has a section that clarifies what it means to be "Struck by" a vehicle.
Where in the SCP's would a CA find information on what to do with an "IME" report once its received into the claim?
Medical Management > Resources > External Resources > External Resources
Which pay code do you use when no other payments are expected?
Pay Code 1
Use Pay Code 1 when no other payments are expected.
What does IME stand for?
Independent Medical Examination
Kevin once played a song from 1985 in which he stated "these are the greatest collection of singers"
What is the name of this song?
What two famous artist wrote it?
What legendary music producer produced it?
We are the World
Michael Jackson and Lionel Richie
Quincy Jones