T2

MAC Esc

100

If a bene filed an appeal, its been more than 60 days and there's no decision in NGD, we can file a?

Redetermination Escalation

200

A suspended claim can only be escalated if its been more than ______ .

120 calendar days

300

What kind of search do you complete to find a purged claim

local claims search

Fraud and Abuse

100

A claim that is denied because the dates of service cross each other isnt fraud, its an ____  ____.

Overlapping Claim

200

A claim submitted even though Part A benefits are exhaused.

Ancillary Claim

Bene Checks

100

How old does a claim have to be before we can submit a stop payment/ reissue?

30 days

200

A check cant be older than __ __ to submit a stop payment/ reissue. 

1 year

300

A check has to say ____ to be able to escalate for a copy of a check.

Cashed or Paid