Week 11
Claims Processing Quiz
Test your knowledge on claims processing with this informative quiz! Whether you're a seasoned professional or just starting out, this quiz will help you reinforce essential concepts.
Topics covered include:
- Claim verification procedures
- Interpreter services contact information
- Understanding claim code meanings
- Retrieving information for claims adjustments
If a provider calls and says a claim overpaid, we should first:
A. Send to PNDJ to verify it is priced correctly
B. Tell them to call their provider rep
C. Tell them we do not re-process claims for pricing issues
D. Price the claim to verify it is priced correctly
The correct phone number for the Language Line (Interpreter Services) for New York is ?
800-522-5566
877-756-4833 PIN 1424
877-756-4833 PIN 1349
202-488-4200
There is an “X” in the sixth position of the claim. What does it mean?
It is a facility claim
It is a Medicare primary claim
It is a crossover claim.
It is all of the above
A claim paid a lower allowance than the provider states it should have. You see OFMC on the override line in streamline. What BL can you go to for a definition of that code?
A. ClaimsXten (CXT) Processing and Adjustments
Information Remark Codes
Home vs Host
Streamline IB Overrides
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