Claims Flashcards
True/False: The Claim Definition File (CDF) handles claims formatting and error checking.
True
Who should fix User Errors:
A. End Users
B. Administrators
A
Who should fix Master File Errors:
A. End Users
B. Administrators
B
True/False: A claim can only exist in a single claim edit workqueue at a time
False
True/False: Only one user can work a specific claim at a time.
True
The ____ provides instructions on how to fix claim edit workqueue errors.
The Claim Edit Assistant/Workqueue Companion
True/False: Reevaluating against the CDF and Claim Edit Workqueues happens in real time.
True
Accepting the Claim Run (Choose all that apply)
A. Confirms Claims were sent
B. Changes the insurance bucket to outstanding
C. Updates the last claim sent date
D. Stamps the claim with the invoice number
E. Prints the paper claims
A,B,C,D
What is the Status of the insurance bucket before claims are processed? A. Open B. Created C. DNB D. Outstanding E. Billed F. Closed
B
What is the status of the HAR before claims are processed? A. Open B. Created C. DNB D. Outstanding E. Billed F. Closed
E
What is the status of the insurance bucket after the claims have been accepted? A. Open B. Created C. DNB D. Outstanding E. Billed F. Closed
D
Late Charges occur: when there are charges in the \_\_\_\_\_\_ bucket and the HAR has a status of \_\_\_\_\_\_\_. A. Insurance, Billed B. Pre-billed, Open C. Self-Pay, Open D. Pre-billed, Billed
D
\_\_\_\_ Creates a new claim that includes the new charges and the old charges. A. Late replacement Claim B. Late charge Claim C. Late charge Write-Off D. Late charge Addition
A
\_\_\_\_\_ Combines all of the charges on the current claim, only available if the account has been billed but a claim has not been sent. A. Late replacement Claim B. Late charge Claim C. Late charge Write-Off D. Late charge Addition
D
True/False: The Late Replacement Gain is the difference between the currently billed values and the values that would be true if you processed the late charges
True
