Week 9
Front-End Claims Quiz: Test Your Knowledge
Welcome to the Front-End Claims Quiz! This quiz is designed to assess your understanding of claim processing and billing practices relevant to the healthcare industry. Test your knowledge with five carefully crafted questions that cover various scenarios you might encounter.
Key features of the quiz:
- Multiple choice questions
- Instant feedback on your answers
- Score tracking for your performance
You are working a front-end claim hitting FKB. Your code is not billed with Medicare, is not a vaccine admin code or dental code and is billed with a 59 modifier. Do you:
Deny the line TFKE
Combine the line with another billed on the the claim.
Review the FKA BL
Override the line with AFKB
Member calls and questions why they have a ER copay when they went to Urgent Care. What do you do.
Advise the caller no problem I can send the claim back to have the copay corrected
Follow the Urgent Care Claims Bluelink and follow the Steps for Phone Inquiries.
Advise the caller the copay is correct and there is nothingyou can do.
None of the above
If you receive a written request from a provider who advises the claim in question processed incorrectly, you have had the claim adjusted and no change in processing has been made. You are working a piece of cora, can you allow the recently adjusted eob to go out as the response to the provider even though there was no change in processing?
True
False
If a Medicare EOB shows ASG N, $Allowed 148.52, $Pd Pov 116.44, $Ded 0.00, $Co-Ins 29.70 what would we use for the Medicare allowed amount?
$146.14
$148.52
$116.44
Blue
Enrollment changes and corrections can be requested for the following reasons:
Requesting a change due to a Qualifying Legal Event (QLE). Examples of this type of event are marriage or divorce.
Requesting a change for legal reasons . An example of this type of event is legal name change.
Requesting a correction of an error that occurred during the enrollment process when the enrollment record was established. Example of this type of correction is a name being misspelled.
All of the above
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