WorksheetsBENEFIT QUOTING
Total questions: 10
Worksheet time: 53mins
What is the rule does apply for the GLOBAL MATERNITY?
48/96 hour rule meaning no prior authorization if services won't exceeded within 48/96 hour
48/96 hour rule meaning prior authorization is required if services would be exceeded within 48/96 hour.
48/96 hour rule meaning prior authorization is required if services would not be exceeded within 48/96 hour.
Continue without provider, given the details below, what would be coverage for the procedure code: 99214.
Member's ID: MUJ 577M78343
Member's Name: BRIANNE BOLANDER
DOB: 04/14/1989
The service would be rendered in the office, outpatient, professional billing rendered by in-network specialist.
The procedure code 99214 is subject to copayment amounting $40 per visit and covered at 100% of the allowed per calendar year.
The procedure code 99214 is subject to copayment amounting $40 per visit and covered at 100% of the allowed per benefit year.
The procedure code 99214 is subject to copayment amounting $40 per visit and covered at 100% of the allowed per year.
The procedure code 99214 is subject to copayment amounting $4.0 per visit and covered at 100% of the allowed per calendar year.
What is the largest solid internal organ?
(a)
What is the percentage coverage for the surgical/diagnostic procedure code 45378? The provider who would rendered the service is Out-of-network.
Use FOBS and use this contract code: 7BYD.
(a)
Continue without provider, given the details below, what would be coverage for the procedure code: 96400.
Member's ID: AN4122538
Member's Name: SPENCER T BROWN
DOB: 12/15/1991
The service would be rendered in the office, outpatient, professional billing rendered by in-network provider.
The procedure code 96400 is subject to deductible $1,000 with a coinsurance of 20% per calendar year.
The procedure code 96400 is subject to deductible $100 with a coinsurance of 20% per calendar year.
The procedure code 96400 is subject to deductible $1,000 with a coinsurance of 20% per benefit year.
The procedure code 96400 is subject to deductible $1,000 with a coinsurance of 100% per calendar year.
Using the details below and using the procedure code 99213, what'll be the coverage?
Member's ID: VHA 797M83219
Member's Name: DENNIS SERFILIPPI
DOB: 06/14/1963
This is an Exam/Visit professional billing, in-network provider, done in the office.
For the procedure code 99213 is subject to $6,550 and it does not have a coinsurance.
For the procedure code 99213 is subject to $6,550 and it does not have a coinsurance. And the benefit period is benefit year.
For the procedure code 99213 is subject to $6,550 and it does not have a coinsurance. And the benefit period is calendar year.
We transfer the call, we do not handle the plan.
Continue without provider, given the details below, what would be the coinsurance for the procedure code: 72114.
Member's ID: AN4122538
Member's Name: SPENCER T BROWN
DOB: 12/15/1991
The service would be rendered in the office, outpatient, professional billing rendered by in-network provider.
(a)
Continue without provider, given the details below, what would be the coinsurance for the procedure code: 72114.
Member's ID: S8W AN5976170
Member's Name: SANDEEP REJI
DOB: 07/13/2001
The service would be rendered in the Free standing facility, outpatient, rendered by in-network provider.
(a)
A health condition or medical problem was diagnosed or treated before enrollment in a new insurance plan or policy.
(a)
These providers who have a contract/written agreement with the insurance at the time services are rendered.
(a)
