Fastest Finger first

The denial for medical necessity is

• CO 22

• CO 16

• CO252

• CO 50

Patient needs to update COB with

• Insurance

• no one

• subscriber

• dependent

After how many questionnaires can we bill the claim balance to patient in case of CO 22 denials?

• 1

• 2

• 3

• 4

CPT is not compatible with the Diagnosis code billed or the number of units exceeds the allowed limit. This is a denial of

• CO 16

• CO 50

• CO 22

• CO 32

A ______ is a formal request that is sent to the payer to reconsider/review the claim that is denied

• COB

• TOB

• ABN

• Appeal

Incase of CO26, the policy

• termed before the DOS

• Started after the DOS

• Both A & B

• None of the options

CO 27 means that the policy

• is active on DOS

• Termed before the DOS

• Both A & B

• None of the options

On a claim, insurance denied with 197. The authorization number (auth #) is found in the host. What would be the next action?

• Rebill the claim

• Call insurance and give auth#

• Wait for retro auth

• Handoff to CBO

There are _ types of authorization

• 1

• 2

• 3

• 4

James is working on a claim. Insurance denied with 27. He checked insurance website and found the insurance is not active on DOS. He didn't check the patient's other visit and billed the amount to patient. Is it correct?

• Yes, since the insurance is not active.

• May be

• No, related visit needs to be checked

• No, he needs to call insurance and reprocess