Claims review

Create an illustration depicting a claims review office, with employees analyzing documents, using computers, and discussing claims details, featuring a professional and collaborative atmosphere.

Claims Review Quiz

Test your knowledge and understanding of claims review processes with our engaging quiz! This quiz is designed to assess your familiarity with policies, procedures, and important details related to claim management.

  • 11 comprehensive questions
  • Multiple-choice and checkbox formats
  • Immediate feedback on your answers
11 Questions3 MinutesCreated by AnalyzingData501
When viewing claims in Cirrus, what does chargeable claim mean?
Delegated Arrangement
Assignment of benefits
Stand claim submission
You can have up to 4 modifiers added to procedure codes.
True
False
Under which section will you be able to view an original claim off of a manually adjusted claim?
Service line
Claim service line
Claim line summary
Provider info
If a BA or BOA call on behalf of a member for a claim, what information are you allowed to disclose? Check all that apply.
Payment information
Diagnostic codes and meaning
Check information if available
Member responsibility
Reason for visit
General claim information
Provider TIN
In Cirrus, what is the tab number for claim summary
6
7
8
9
What are the 2 types of claim forms?
UB-40
CMT 1500
CMS 1500
UB-04
What does the paid amount mean on a claim?
The amount the provider writes off or reduces
The amount the member is paid
The amount UHC/Oxford paid
The amount the provider is charging for the visit
In ACET viewing a claim, what information is available on the claim search page? Check all that apply.
Network
Status Date
Patient responsibility
Provider
Cirrus claim ID number
Status
Tax ID
Primary DX
External claim number
Event type
Encounter
Benefit level shows in provider is INN or OON
True
False
What are our delegated arrangements? Check all that apply?
Evicore
Optum Rx
Orthonet Orthopedic
Optum Healthcare Solutions
Optum Health Transplant Services
Optum Health Physical Health
Optum Health Dental Care
Optum Health Infertility Services
Orthonet Occupational Therapy Services
Before reviewing a claim with a BA or Broker, you must verify the following. Check all that apply
Member's DOB
Member's phone number
Member's status with the group
Permission to speak on the member's behalf
{"name":"Claims review", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Test your knowledge and understanding of claims review processes with our engaging quiz! This quiz is designed to assess your familiarity with policies, procedures, and important details related to claim management.11 comprehensive questionsMultiple-choice and checkbox formatsImmediate feedback on your answers","img":"https:/images/course3.png"}
Powered by: Quiz Maker