Claims
A claim is electronically submitted on January 9, 2025, and the DOS is October 20, 2024. What will the first two digits of the claim # be?
What is 25?
When are cases created?
What is every call/interaction
Claim Status 01 means?
What is Accepted; Awaiting Batch (*may be pended)?
Who is eligible for Medicare?
What are U.S. Citizens & Permanent Residents, Age 65+, Under Age 65 w/ disabilities, ESRD?
In the sitcom Friends, what is the name of Ross' monkey?
Who is Marcel?
Claims that end in "00" mean what?
Explain Lock for Closure
What is additional follow up required by agent?
Claim Status 11 means?
What is Pended; Awaiting Batch?
Medicare is overseen by this agency.
What is Center for Medicare and Medicaid Services (CMS)?
This American Vocal Harmony Group sings the song Motown Philly.
Who is Boyz II Men?
How many times has Claim #25B1234567802 been adjusted?
What is 2?
Name the (3) case status options.
What is Open, In-Progress and Closed?
Claim Status 15 means?
What is Pended with Errors?
Complete the saying: If Medicare ___, we ____. If Medicare, _____, we _____.
What is If Medicare pays, we pay. If Medicare denies, we deny?
This city is nicknamed "The Emerald City"
What is Seattle?
What will the first (3) characters look like for a paper claim received on March 2, 2025, for date of service of March 2, 2024?
What is P25?
You will use this category for when providing a member with the status of their HIPAA Authorization Form.
What is Privacy?
Claim Status 88 means?
What is Encounter Reprocessed as Claim?
What is Medicare Part A?
What is Hospital Insurance?
The capital of the Phillipines.
Shout out to Josan!
What is Manila?
What are the top (3) member denial reasons?
What is service is not covered, benefit was not pre-authorized prior to being done, The service was done before or after the coverage dates.
Give one call scenario where you will create more than one case
What is Claims and Benefits?
Claim Status 95 means?
What is Adjusted Encounter?
Using Facets, is member K9054110201 on an individual or family plan?
What is Family Plan?
"I'm gonna make him and offer he can't refuse".
What is the Godfather?