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

Week 11

Claims Processing Quiz

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