Claims
Benefits
Plans
Clients
Misc.
100

Claim form that is used for Institutional Claims?

What is a UB-04?

100

Category of benefits a Specialist Office visit would fall under?

What is Professional Services?

100

These 6 plans offer the Gap Referral.

What is Enhanced Buy-up Kootenai County, Buy-up Kootenai County, Core Plan HSA Kootenai County, Enhanced Buy-up Inside 4 Northern ID Counties, Buy-up Inside 4 Northern ID Counties, Core Plan HSA Inside 4 Northern ID Counties.

100

MCC Plan

What is MultiCare

100
1 member, up to 3 claims
What is the limit for a non-client provider?
200

Common reasons a claim will deny? (3)

What is the CPT code, Diagnosis code, or Place of Service?

200

If a code in CPT checker shows excluded, where should we check next?

What is the BQT?

200

This is an employer-funded account that employees can elect if they are enrolled on their spouse's group health plan. This plan reimburses eligible out-of-pocket medical expenses that were not paid by the spouse's plan, such as copays.

What is the MERP plan?

200

Plan Code FRHSHDH

What is Faith Regional Health Services?

200

Where to direct a call for Employment Verification?

Who is Brandi Shaffer-Villalon? (Will also accept phone number or email.)

300

How to see the extensive reason for a claim denial.

Audit button.

300

Where do we find if there is dependent maternity on a plan?

What is the Group Home BQT

300

This plan offers a Provider Waiver.

What is the MCC Plan.

300

Plan Code GFPCPO.

Whst is Great Falls Public Schools?

300

15 Calendar Days

What is the turnaround time for a PA?

400

What is the correct modifier for a telehealth visit?

95, GQ, or GT

400

CPT code 71045

What is Labs/Diagnostic Testing/Radiology

400

Providers in Spokane are Excluded

What are the 5 northern counties of Kootenai plans. (Stating all of Kootenai will not get points!)

400

Plan Code PTCNR.

What is Port of Tacoma?

400

Name the box where it displays which claims have applied to a selected accumulator.

What is the Benefit Details box?

500

Frequency Code 6 on a claim?

What is Adjustment of Prior Claim

500

Member goes for a PCP visit, but the provider is listed as a NP?

What is a specialist office visit?

500

You can find the link to the excluded provider list for Kootenai here.

What is the Special Information at the top of the BQT?

500

Plan Code SMCVEBU

What is St. Mary's Hospital & Clinics and Clearwater Valley Hospital & Clinics (Or just St Mary's.)

500

Services paid from these types of providers are generally paid at the In-network level even though they are not contracted.

What is a Recognized Provider?