CRM Screens
What are the CRM screens that you will use to retrieve claims information?
Claim summary page
Claim detail page
What can we ask the member to gather information about a claim?
Date of Service
Provider/facility name
Total charge amount
Cual es el lugar mas frio del mundo?
El corazon de ella.
How many times can I reach out to CRU about an specific claim?
Just once.
Cuando finalizo la II Guerra Mundial?
La II Guerra Mundial finalizó en 1945.
What information can you find on the claim detail page?
DOS
Source
Claim type
Authorization number
Platform
In which cases are we allowed to transfer a call to CRU?
NEVER.
What are the 3 CAS Clients and their states?
CAS Client 56 - TX, AZ
CAS Clients 57 - FL, GA
CAS Clients 58 - All other markets
What is the command line for the MDI screen?
MDI,SSN,Suffix,First Name,RL,MMYY
Quien gano el mundial del 2002?
Brasil.
What is the timeframe for a pended claim to finish processing?
There is no time frame.
When can we call a provider?
Member needs reimbursement from the provider.
Balance billing
Provider claim not on file
A corrected claim is needed
What's illegal to sell in Columbus Ohio on Sunday?
Corn Flakes.
What is a claim?
Notification to an insurance that payment of an amount is due under the terms of the policy.
Cual es la capital de Mongolia?
Ulan Bator
What is the CAS claim prefill link for?
Access the web system and opens the CAS screen MHI.
What are some reasons a claim can be denied?
No authorization on file
Services are not covered
Incorrectly submitted
Missing Information
Cuantos puntos tiene un dado?
21
What are some examples of Health Care?
Skilled nursing
Physical therapy
Occupational therapy
Registered Dietician
Where se produce la insulina?
En el pancreas.
What info can be found on when the line item is expanded?
Units
NPI
TIN
POT
Cause codes
Name scenarios where PaF cannot help?
G&A
Home Health Claims
Skilled Nursing
Qué año llegó Cristóbal Colón a América?
Cristóbal Colón llegó a América es en 1492.
En que año se hundio el titanic?
1912.
"Vive en una piña debajo del mar..."
CONTINUE THE SONG
* Bob Esponja Theme Song *