Understanding Facility Claim Processes
Understanding Facility Claim Processes
Test your knowledge on facility claims with this engaging quiz designed for healthcare professionals! Understand the complexities of billing and coding, and ensure that you are familiar with the essential forms and regulations.
Are you ready to dive deep into the world of facility claims? This quiz covers:
- Claim forms and types
- Value codes and revenue codes
- Authorization processes
- Common discharge statuses
What is the name of the facility claim form?
UB04
HCFA 1500
Facility Form
UB1500
Facility claims can be outpatient or inpatient.
True
False
Check All That Apply: The Information that should be verified on your claim image:
Value Code
Bill Type
Provider
Member
Statement Covers Period
Line Items Section
Diagnosis Codes
Admission Date
Discharge Status
Keyer ID
A value code submitted by the provider has to have ____ digits.
4
5
6
3
The authorization is approved for revenue code 0128. The provider billed revenue code 0124. What are the claim/line level denials that should be used?
A26/A27
I45/I46
G07/G39
F02/A47
Ancillary charges on an inpatient claim should deny with ex code _____.
A47
A37
N17
M37
The most common discharge statuses are ____ and ____.
01, 47
30, 47
01, 30
07, 47
An accommodation should be used instead of the contracted rate for an INN provider.
True
False
Bill Type 111 is ___
Hospital Inpatient Admit through Discharge
Hospital Outpatient Admit through Discharge
Clinic Inpatient Admit through Discharge
Clinic Outpatient Admit through Discharge
Value Codes are located in which box on the claim image?
24
1
56
39
If your claim shows value code 1528, it should pay at the ____ rate shown in ultra blue, the price calculation tab or by using webstrat.
APG
CPEP
Web
Per Diem
The description of revenue code 0126 is _____.
Detox
Psych
Rehab
None of the Above
When determining if a claim is BH or medical, if a value code is billed, it is used to determine if we process or not.
True
False
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