WorksheetsReducing Unprocessable Claims (Part A)
Total questions: 10
Worksheet time: 5mins
National Government Services 2020 1st Quarter Data shows what percentage of claims rejecting for beneficiary name and MBI?
34%
25%
9%
Claim rejections for beneficiary name and MBI can be avoided when providers do what? Check all that apply.
Collect beneficiary data
Copy insurance cards
Check eligibility via IVR or NGSConnex
The beneficiary’s nick name can be used when submitting claims to National Government Services.
True
False
Beneficiaries enrolled in Medicare via Railroad Board, have their claims submitted to Palmetto GBA and not National Government Services.
True
False
National Government Services 2020 1st Quarter Data shows what percentage of claims rejecting for provider data?
24%
25%
9%
When submitting claims for specific laboratory and diagnostic radiology services, what is required on the claim?
Nothing
Ordering and referring provider’s NPI, first and last name
Provider nick name
Remittance advice with MA130 means a claim was rejected and is unprocessable, because the claim had incorrect, missing or invalid data. What are your next steps?
Reopen
Redetermination
Resubmit a new claim with correct information
National Government Services 2020 1st Quarter Data shows what percentage of claims rejecting for CPT/HCPCS codes?
24%
19%
9%
When submitting claims with Not Otherwise Classified codes (NOC) or unlisted codes, what is required?
Nothing
CPT/HCPCS codes
Documentation to process claim
When submitting claims with Codes and modifiers 22 or 52, what is required when submitting the claim?
Nothing
CPT/HCPCS codes
Documentation to process claim
