WorksheetsHEGI And HEHI Training Assessment Quiz
Total questions: 25
Worksheet time: 13mins
What is the different types of Claim that we get on daily basis
Reimbursement
Cashless
OPD
All of the Above
What is a PA Claim
Personal affected claims
Personal attire claims
Personal Accident claims
None of the Above
What is a check list in Processing
Tool for processing the claims
Tool for raising queries
Tool for making perfect
None of the above
Broken bones is an indemnity or Benefit product Choose from the following
Indemnity
Ans is C
Ans is A
Benefit Product
What is broken bones?
Covered In Personal Accident policy
Covers Fracture / broken bones due to Accident
Claim is paid basis bone/ bones involved i.e. Single or multiple fracture and simple or compound fractures
All of the Above
What is TTD?
Temporary Timely disappearance
Temporary Total disablement
Temporary Total destruction
None of the Above
What is Permanent Disability?
Health suraksha Policy
Arrogya Sanjeevani
Sarv Suraksha policy covers both PTD & PPD
All of the Above
What is loss of mastication?
Total ability to loose the sight
Total ability to loose hearing
Ans is A
The total and irrecoverable loss of ability to chew food
What are the docs required for Accidental Death?
FIR/MLC
Post Mortem Report
only A & B
None of the above
What is Garage Cash?
Indemnity Product
Non Medical Benefit Product
All of the Above
Non of the Above
What is LOJ?
Loss of Joy
Loss of Jump
Loss of Job
Loss of Justice
What is required for LOJ?
Policy covers loss of Job due to merger and acquisition or due to other reason like closedown of company or department or project etc
Self resignation; Job loss due to disciplinary action is not covered
Policy covers 3 EMI or Sum insured which ever is lower
All of the Above
What all is present in Home suraksha LOJ?
Company shut down
Process shut down
Project Shut down
Self resignation; Job loss due to disciplinary action is not covered; temporary or contract basis job, on probation etc
A,B And C
What is required for NEFT Entry?
Cheque/Passbook
Passport
only B
Driving license
Remarks after updation of NEFT?
NEFT details attached and proposer name matched with the details.
Endorsement done and Proposer name perfectly matched with CIS sheet
Endorsement done policy copy attached with claim
All of the Above
What are the docs required for KYC?
Passport
Only option A
Driving License
only option A and C
What is a financial error?
Room rent entered twice
·Not entered medicine break up
Only A
A & B Only
What is a Procedural error?
·X-ray charge put into blood count head and vise versa
Change of Hospital name and address in Reimbursement cases.
Change of Admission and discharge date
All of the Above
KYC is Required only when the claim amount is greater than or equal to 1 lakh
True
False
May be
Only C
What are the types of interactions?
Payment related interactions
Query request interactions
Closed cases interactions
Only A B AND C
What is the TAT for Complaints?
No Dependency - Daily Basis
Internal Dependency- 0 to 3 Days
External Dependency - 0 To 4 Days
All of the Above
TAT Of Non Complaints
32 hrs
10 hrs
Option B
24 hrs
What are the types of Send back errors?
NEFT Error
Bill Entry Error
Tariff Error and KYC Error
All of the Above
What all you check for claim segregation procedure?
Bills and related documents to be separated based DOA and DOD.
Before claim separation discharge summary to be checked as per hospitalisation period(Less than 24 hrs or not. For day care it is an exception and should be main claim
If there are 2 discharge summary, In first discharge summary if it is less than 24 hrs based on admit time we need to consider single claim for both
only A B And C
Which Team investigates the claims?
Risk and Law unit
Risk and loss mitigation Unit
Only option A
None of the Above
