Show:
LIS and LEP Premium Discrepancy Reconciliation – Group
Negative payment file
Payment preference
Group refund processing
Premium Invoice Adjustment
100
True or False: By the 6th of every month, ika automatically runs the invoicing process to calculate member and group invoices and generate the RM08 Invoice Extract.
True
100
When does IKA apply automated clearing house payments directly to the member's account?
1st day of the month
100
Health Plan defined unique identifier for an employer group.
Group ID
100
Where should be the BPO processor route the request once they verified the amount?
Visiant Billing Ops
100
Invoices that have not yet been posted as receivable item.
Created
200
A list that will be escalated to enrollment team.
LIS/LEP Discrepancy Escalation Log
200
What is the subscriber ID/member ID sent via pre-note file
Account Number
200
_____ is used to select the right member if the search lists down multiple members.
HICN
200
How many days does the Visiant Finance have to complete the drafting check?
2 business days
200
True or False: Invoice ID is a unique number that identified a particular invoice for a group for a particular invoice month
False - member
300
This report should only contain groups and members with discrepancies.
LIS/LEP Variance Recon Report
300
What is the next step after the reversal?
Create and send the manual letter
300
DB stands for?
Direct Bill
300
CP stands for?
Coverage Period
300
This leads you to the window where you can perform your invoice search.
New Invoices
400
In checking LIS discrepancies, if the value of MEM_VAR column is note equal to zero, what should you select in the Election List screen to check if the member is listed with discrepancies?
Discrepancy Qs then Demographic Discrepancies and in the Discrepancy dropdown menu, select LIS.
400
What are the payment type/source?
ACH or LBX
400
The level at which processor configure the premium rates for the group: Plan, Group-Plan, or Group-Division Plan.
Premium Level
400
The ______ section of the screen updates to show the adjustment.
Current Batch Summary
400
True or False: If an invoice’s status is Created, then ikaSystems applies the adjustment to the latest invoice. If an invoice’s status is other than Created (Partially Paid, Not Paid, PAID), the manual adjustment is tagged as Pending by the IkaSystems until the next invoice is generated. ikaSystems automatically applies the adjustment and is reflected in the next billing cycle.
False - current
500
True or False: The group invoices detail out the CMS Amount Due and Member Amount Due for each member in the group, and sums up the total Member Amount Due to determine the total amount owed by the member for the month. The CMS Amount Due is applicable only to members with LIS. This field will be $0 for non-LIS members. The Member Amount Due is applicable to any member (LIS or non-LIS) that has a monthly premium due in addition to their LIS payment (if applicable).
False - total amount owed by the group
500
What is the step if you encountered any system error or any issue that may affect the expected result or next step?
Escalate
500
What to click to save the settings/changes?
Update
500
What should be closed in MyBriefcase once the adjustment has been completed?
Inquiry
500
If there is a Pending Manual Invoice Adjustment that matches the adjustment that needs to be deleted based on the completed analysis of the report, file, or Briefcase Inquiry what should be done?
Locate the row that contains the manual adjustment that needs to be deleted then click the delete icon under the delete column.