I
What are the claim forms we use
CMS 1500
UB 04
What is the 1st step you do after you searched a claim?
Resubmit
Out of following EVH plan capabilities in which part we are going to work?
Back Office
What is COB?
Coordination of Benefits
What is ACA?
Patient Protection and Affordable Care Act
What is the tool name you use to process the claims?
Aldera
The claim number should never include any alphabetical characters.
TRUE OR FALSE?
FALSE
After the individual has been enrolled in the plan, they are known as "_______"
All of the above
OOPE Stands for?
Out of pocket expenses
Types of provider
PCP
Referring
Rendering
Billing
What are the patient's responsibilities?
Copay
Deductible
Coinsurance
What does Z status mean?
Pend
Which of the following team works on PCP assignment task?
Eligibility and Enrollment
What does HMO and PPO stand for?
Healthcare Maintenance Organization
Preferred Provider Organization
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
How many digits TIN consists of?
9
What is OON & INN?
Out of network
In network
Aldera must be open in “_____________” for better performance.
Google Chrome
Firefox
Internet explorer
Aldera has its own explorer
Internet explorer
Which department are you going to work for?
Passport/Claims
What does PCP stand for?
Primary care physician
Different names of patient
Member/Subscriber/Policy holder
What is Frequency 7?
Corrected claim
Out of following choose the correct definition of remark code.
The code specifies why the claim denied from auto adjudication
In which plan a PCP is required?
HMO
What is the 1st step you do after you have searched the claim?
Resubmit