GW GRS Boot Camp Jeopardy

Billing Essentials

100

This is where LMS courses, patient calls, and High Fives are located.

Salesforce

200

The system in which you work

Prime Suite

300

Clear Harbor, Navigant, and Omega are examples of this

BPO (Business Process Outsourcing)

400

Roles include checking claim status, working rejections, trend spotting and filing appeals.

Claims Analyst

500

These are the four major roles of a claims analyst.

Claims Processing Work, A/R Analysis, Automation & Optimization, and Client Relationship.

Medicare

100

Medical Insurance: Office Visits, Surgeries, Labs

Medicare Part B

200

Part of Medicare that goes to private insurance companies

Part C or Medicare Advantage

300

Prescription Drug Insurance

Medicare Part D

400

Medicare Optional Plan

Medical Supplemental Insurance (Medi-Gap)

500

Regional entities responsible for day-to-day administration of Medicare

MAC or Medicare Advantage Contractors

Prime Suite

100

First step in claims submissions

Create Claims

200

Institutional claims are submitted on what type of claim form

UB-04

300

Where to view the story of the patient's visit history

Account Information Page

400

How to view claims past follow-up

Claims Maintenance

500

A/R Analysis, Provider Revenue Summary, & A/R Summary are types of this

EOM Reporting

Payment Posting

100

EOB

Explanation of Benefits

200

Copay, Co-Insurance, or Deductible

Patient Responsibility

300

Used by client to upload paper EOB

Box.com

400

1 line pays and 1 line denies

Paid Partial

500

Gives the reason why a claim or CPT was denied

Claim Adjustment Reason Code

Payers

100

The Mother of Rules

Medicare

200

Health Maintenance Organizations require this

Primary Care Physician or PCP

300

Injured on the job

Worker's Compensation

400

Insurance company decides on whether a procedure is covered and under which circumstance

Coverage Determination

500

Complete listing of rates to pay doctor or other provider/suppliers

Fee Schedule