TFL QUIZ

1.If you receive the status on call as the claim is denied as TFL has expired then what will be your next valid questions?

May I get the denial date?

When did you receive the claim?

How much is the Timely filing limit?

None of the above

2.If you receive the status on call as the claim is denied as TFL has expired but the claim was received within TFL then what will be your next question?

Could you please send the claim back for reprocessing since the claim was received within TFL?

Can we appeal with POTF?

What is the fax# or Mailing address to send an appeal?

All of the above

3.If you receive the status on call as the claim is denied as TFL has expired and the claim was received after TFL and the POTF is available then what will be your next questions?

Can we appeal with POTF?

What is the fax# or Mailing address to send an appeal? & What is the appeal limit?

May I have the claim# & call ref#?

All of the above

4.If the claim is denied for TFL expired incorrectly and the rep sends the claim back for reprocessing then what will be your action?

Send an appeal to the insurance

Set the follow-up for the TAT

Write off the claim

None of the above

5.If the claim is denied for TFL has expired and the claim was received by the insurance after the TFL period crossed and you do have the POTF and the rep confirms that you can appeal with POTF then what will be your action?

Send an appeal to the insurance

Set the follow-up for the TAT

Write off the claim

None of the above

6.If the claim is denied for TFL has expired and the claim was received by the insurance after TFL period crossed and there is no POTF what will be your action?

Send an appeal to the insurance

Set the follow-up for the TAT

Write off the claim

None of the above

7.TFL must be calculated from?

Date of service (DOS)

Received date

Date of denial (DOD)

None of the above

8.Which of the following option cannot be considered as POTF?

An initial filed claim to the same insurance which is not received by the payer

Initially rejected claims

TFL denial EOB

Initial billing to any other payer

9.If the claim has DOS as 01/25/2023 and TFL is 120 days and the claim was received by the insurance on 05/25/2023 then should the claim be denied for TFL expired?

TRUE

FALSE

10.Appeal filing limit (AFL) must be calculated from?

Received date

Date of service (DOS)

Date of denial (DOD)

None of the above

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