Mark Safe
Random stuff
Random stuff
what goes up and down the stairs without moving?
Rug
how many digits should a claim include?
15 digit numbers
what is the question that no one could answer in the affirmative?
ARE YOU ASLEEP?
were running a race and you passed the person in 2nd place, what place would you be in now?
2nd place
What is the client number for a Texas member?
56
what can you catch but not throw?
cold
What Federal or State Program was the one in charge of creating the Cost-Share Protected?
Medicaid
what is the next number? 1, 3, 4, 7, 11, 18,
29
Members will have _____ to restore the required level of Medicaid eligibility.
6 months
a benefit period is a 60-day window in which members can be readmitted to an inpatient facility. true or false?
true
Standard health insurance form approved by American Medical Association (AMA). Also referred to as a HICFA.
CMS 1500 Form
What is the claim status that is a combination of covered services and rejected charges?
Partially Denied
In a one-story pink house, a pink chair, – everything was pink!What color were the stairs?
there weren’t any stairs
What does NPI stands for?
National Provider Identifier
nvestigates wrongful activity for all business groups. They are responsible for investigating wrongful acts.
Special Investigation Unit (SIU)
members who have been certified as terminally ill, have the option to elect and receive ______ care.
Hospice Care
to which system is the claim send to make a first attempt to process the claim?
Claims Administration System
what has 4 eyes but can’t see?
mississippi
You throw away the outside and cook the inside. You eat the outside and throw away the inside
Corn
What Intent will you use if the member or a provider called wants to check status of a check?
Intent: Check Info
M*I, (SSN),(suffix),(Member's name),(Relationship code),(Claim#) What's the missing letter of this control line?
H
__?__ are used to determine the status and resolution of a claim.
EX Codes
You walk into a room with a match, a karosene lamp and a candle. Which do you light first?
match
All member EOBs are suppressed (not-mailed) for D-SNP plans. True or false
true
M*I, (SSN),(suffix),(Member's name),(Relationship code),(mmyy) What's the missing letter of this control line?
D, A