Following Up On Outstanding Claims Ch.7

Question 1

Workflow diagram

Answer 1

Question 2

Documenting your findings:
which activity do you perform when the payor did not receive the claim and you need to send them a new claim?

Answer 2

Resubmit claim

Question 3

Which activity do you perform when you can’t work the claim right now so it shouldn’t be on your activity tab?

Answer 3

Defer

Question 4

Operational decisions: how will you divide the insurance follow up workload?

Answer 4

Financial class, payer, specialties, alpha-split, other

Question 5

Operational decisions: what factors would your organization use when calculating “score” columns?

Answer 5

Amount outstanding, age, number of denials, payer, denial types

Question 6

Review ch.7: what activity can be used to document your phone call with a payor?

Answer 6

Call Payer

Question 7

Review ch.7: true or false: when deferring a claim, the claim leaves your work queue for the days you defined.

Answer 7

False: the claim doesn’t leave the WQ. It stays in the WQ but moves to the User Deferred Tab.