Purple Rain
Remember The Time
The Beautiful Ones
Billy Jean
Sometimes It Snows In April
100

According to RSI what is the source of truth? Latitude or the client system ?

What is the client system

100

What is the term for an agreement that determines which insurer has primary responsibility for payment an which has secondary responsibility

What is coordination of benefits

100

What is the billing claim form for the professional charges

What is a CMS-HCFA 1500

100

What is covered under Medicare Part B?

What is outpatient services

100

What is the State Government Plan/Payer of Last Resort

What is Medicaid

200

The electronic notification of how the claim was processed and/or paid is known as?

What is an ERA or electronic remittance advice

200

What is the practice of reviewing requests for hospital admission before the patient actually enters the hospital known as?

What is pre-admission certification (Pre-Cert)

200

A federal government insurance program for persons 65 or older

What is Medicare?

200

What is the term for the justification of medical services as reasonable, necessary or appropriate

What is medical necessity

200

The process by which a patient or provider attempts to persuade an insurance payer to pay more of a denied medical claim is known as what?

What is an appeal

300

What is the four-digit code grouping that is used on hospital/facility claims only

What is a revenue code (REV code)

300
In Latitude, what information comes over on a transaction file?
What is payments, adjustments, or credits
300

The payment for a claim is known as?

What is reimbursement 

300

Medicare coverage for a medical condition in which a person’s kidneys cease functioning on a permanent basis

What is ESRD or end stage renal disease

300

What is covered under Medicare Part C?

What is HMO plans

400

Medical services performed on an outpatient basis without admission to a hospital or other facility

What is ambulatory care
400

In what year did all the states participate in Medicaid?

What is 1982

400

DAILY DOUBLE: What is timely filing limit to submit an inpatient appeal to Medicare?

What is 120 days from date of processing

400

What is the term used to describe the balance in the Patient Accounting System reflecting an opened outstanding claim?

What is insurance accounts receivable or IAR

400

Drugs and prescriptions are covered under what part of Medicare?

What is Medicare Part D

500

What is the application process for a provider to participate with an insurance carrier?

What is credentialing

500

What set of codes on a claim form describe why a procedure/service was performed for said patient

What are ICD-10 or diagnosis codes

500

What drives the medical reimbursement on an inpatient claim?

what is the DRG or diagnosis-related group

500

What Remark code is used when a CPT/HCPCS code denies for no authorization/ pre-certification?

What is CO-197

500

In Medicare, HIQA is abbreviated for?

What is Health Insurance Query Access