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Do you know your rework strings?

Authored by Anne Helbling

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Do you know your rework strings?
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5 questions

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1.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

What Rework String would you use for this call claim that came from PCR, on 12/13/22?

NEW INFORMATION RECEIVED TO REWORK AN ADJUDICATED CLAIM         

SYSTEM ISSUE PER COMMUNICATIONS RELEASED ON 122322 - PLEASE DELETE OFF ALL  

LINES AND PROCESS PER INQ SCREEN OR THE IOP.  ANESTH CODE NEEDS TO BE ON ONE

LINE AND NOT SPLIT OUT ON MULTIPLE LINES.  SYSTEM HAS BEEN FIXED.           

RA122322Z45

RA121322Z45

RE122322V15

RE121322V15

Answer explanation

Correct answer RE122322V15.

PCR did not review the issue since it was a system issue.

2.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

RA032023R45-New information received to rework an adjudicated claim

Original DCN 230320055341 this is not a duplicate claim this is a corrected claim to

EBY12XG8P00. Please reprocess thanks

RA032023R41

RE032023H28

RA032023R45

RE032023H14

3.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

RE032123H14-Incorrectly denied or paid, not otherwise described Urg02 Pls review to reprocess this claim. There is no billable limit for physical therapy thanks. diana/7579371373

RA031223H15

RE031223H23

RE032123H14

RE032123H15

4.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

RA031723R45-New information received to rework an adjudicated claim

Original DCN 230317077834. A corrected claim has been received with addition of modifier Q8 for procedure code 11055. Please reprocess. Thanks

RE030723R45

RA031723R45

RA031723R41

RA031323R41

5.

MULTIPLE CHOICE QUESTION

30 sec • 1 pt

RE032123R42-All other fee errors. RMSO procedure code 70491 is not payable as the billed procedure code is not authorized. We paid $208.53 for this claim.

We should have allowed and paid $0.00. This is an overpayment of $208.53.

Member has no responsibility.

RA032123R42

RA032123H42

RA032123D41

RE032123V42

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