Navigation
Service Conversion
Plan/Product Administrative Components
Configure Providers
Claims
100

These two keyboard commands allow you to navigate back and forth between Applications and Open Work? 

What are F11 and F12

100

All Service ID's, Service Codes or TOS codes must first be defined in this application?

What is the Service ID Description Application?

100

A Plan is nothing more than this

What is a name and an ID?

100

These are three situations that would require more than one Practitioner record to be established

What are Multiple primary addresses, Multiple tax ID's, Affiliated with multiple provider groups


100

This stops a claim from fully processing

What does an Error message do?

200

This Window Menu option allows you to close all active / open applications?

What is Close All applications 

200

It's the application where you find the Service Procedure, Service Revenue Code and Service Code Conversion Prefix

What is the Class/Plan Definition Application?

200

The Product application contains the Indicative section, Business Info section, Variable Components section, Capitation Rates Factors section, Notes section plus this section

What is the Components section?

200

Other than Primary, a Practitioner record can have only one of these addresses effective at a time

What is a Remit address

200

01, 02, 11, 15, 91

What are claim statuses? 

300

This keyboard command executes a Search when the cursor is in a searchable field? 

What is F7

300

These are also known as the CMS 1500 and the UB04?

What is the Medical claim and the Hospital (Facility) claim

300

This application/component holds the "PCP Required" check box

What is the Administrative Information (AIAI)?

300

It is the relationship between a Common Practitioner record to a Practitioner record?

What is One to Many?

300

These are the three main functions recognized in processing a claim

What are Eligibility, Service Pricing and Service Payment?

400

This is what is known as the "wildcard" when using the search functionality?

What is the percent (%) key

400

It's another word to describe a secondary conversion that can be performed at the product level

What is Supplemental?

400

This is another way to describe the Line of Business

What is a bank account?

400

IPA, Provider Group, Facility and Practitioner

What are the four types of providers?

400

This is the choice under the View menu option that allows you to see product information as well as Variable Components and Components

What is Products and Prefixes?

500

These are the three tabs at the bottom of the navigation pane?

What are Open Work, Favorites and Applications

500

These are the three base tables that are accessed by Facets during the initial conversion process


What is the TPCT, SECT, RCCT?

500

These are the three Variable Components?

What is the Deductible Rules, Limit Rules and Service Payment?

500

This is the type of information link to the Common Practitioner record and the Practitioner record


What is Static Information (Common Practitioner) and Dynamic Information (Practitioner)

500

These are the two main sections tabs in the Line Items section of the Medical Claim Processing application

What are Line Items and Price Calculation tabs?