Week 11

A colorful illustration depicting healthcare claims processing, with elements like claim forms, calculators, and communication devices symbolizing help and verification.

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
4 Questions1 MinutesCreated by VerifyingClaims27
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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