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Worksheets

Claims

Total questions: 10

Worksheet time: 5mins

Name
Class
Date
1.
How many days does a participating provider have to file a claim?
a)
30 days
b)
6 years
c)
2 years, 3 months, 4 days, 5 hours and 6 seconds (and 7 milliseconds)
d)
180 days
2.

Melissa is a dependent on her parent's policy, according to the Birthday Rule, if her mother's dob is 7/7/77 and her father is the primary when is her father's dob?

a)

7/7/79

b)

7/7/76

c)

1/12/80

d)

7/7/77

3.

True or False. Prompt Pay mandate requires that the insured be notified of a delay if a claim cannot be adjudicated within a 30-day period.

a)

True

b)

False

4.

Using Claim# 05-061515-251-67, what number represents the Julian Date?

a)

251

b)

061515

c)

67

d)

None of the above

5.

Which code is not used in a CMS-1500

a)

Revenue Codes

b)

Modifiers

c)

ICD-9/10 Codes

d)

POS Codes

6.

Determining primary payment source when a 2nd insurance policy has financial liability is...

a)

Claims Review

b)

Authorization

c)

Coordination of Benefits

d)

Explanation of Benefits

7.

Find the claim... Local claim, DOS: July 17, 2010 Electronic, Original

a)

01-03015-0605-95

b)

05-071710-028-70

c)

27-071710-009-45

d)

80-071710-288-12

8.

File a Corrected claim when...

a)

Claim never biled

b)

Additional Info requested

c)

EOP received with claim hold code ECN

9.

What application group allows you to record, process, track, and run inquires on the hospital and medical claims?

a)

Medical Claims

b)

Claims Processing+ITS

c)

Customer Service

d)

ITS Application Support

10.

If an appeal is not found in Care Radius, look in Webnow or DocRequest to see if it has been received...True or False

a)

True

b)

False