NEW
Font size
WorksheetsBCBSNC Claims
Total questions: 11
Worksheet time: 6mins
What is a CM 1500?
1. Professional Claim (Paper)
UB04 Institutional claim
HPCS II Codes
CPT codes
What is a UB04 and how many codes are used for a UB04?
Institutional Claim (5)
To many to remember
Professional claim (4)
Institutional Claim (9)
Some claims must be manually keyed into what system?
Docrequest
Care Radius
PowerMHS
Service 1st
The determination of a claim may result in different claims processing activities. Where do you review for more information on how to properly create activities for a claim (Service 1st)?
Call Handling Job aid
Activity Routing Job Aid
Facets - Call Subjects, Categories and Task Routing
There is no job aid
Member wants to know there claim status what do we give them?
6 components
10 components
2 components
4 Components
When a claim is split into two claims what is the hold code?
ER
BED
ST
EP
A mailback code, what is hold code M1 description?
Give description of procedure
Take a procedure
be great
Paid complete
If claim status is 11,15,16 what does it mean ?
Tell the caller to call someone else
Tell the caller I'm sorry But I cannot
tell the caller to allow more time for processing
Tell the caller I don't know....
The Prompt Pay requirements became effective on what date?
01/01/2012
02/03/2019
07/01/2001
03/01/2001
If the claim remains unpaid after 60 days, the insured and the provider will be sent a what?
Delay in processing
Claim Processing Requirements
Mobius
Corrected Claim
Who was the toughest member yesterday?
Ebony
Jakemia
Sara
Latecha
