Professional - Week 1-2
Help!
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| Where in the FAM would you find Noncovered Procedure Codes? | show 🗑
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| show | 12
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| show | DocRequest
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| If the 7th digit on a claim is 7-9, how was the claim received and where do you go for the information? | show 🗑
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| If the procedure code begins with a "G", or ends with a "F" and .01 was charged, what is the denial? | show 🗑
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| What are the 3 Assistant Surgeon modifiers? | show 🗑
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| show | 17%
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| show | Always pend to MED.
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| If the direction of payment is "85", who will recieve the payment? | show 🗑
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| When will you see the EOB remark code T059? | show 🗑
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| What are two names that describe the claim form submitted by a Provider? | show 🗑
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| show | If the provider is part of the CNC/HNS network, and they file to FEP first instead of through the CNC/HNS program.
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| show | The FAM and SOPs.
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| True or False. If Medicare denies a procedure, we must deny since Medicare is Primary? | show 🗑
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| If a patient has double coverage, Med B. is Secondary, State Blue Cross is Primary...how many EOBs will you need to process their claim and why? | show 🗑
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| show | False. It's the Procedure/HCPCS code.
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| show | False, to be a duplicate it must have the same everything.
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| RF1031 and RF1032 are used for what purpose(s). | show 🗑
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| The most commonly filed POS (Place of Service), on professional claims is what number and what does it mean? | show 🗑
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| The following claim dispositions 9, 1, 2, mean? | show 🗑
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| show | To check provider status for DOS.
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| show | Venipuncture and Bundling
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| show | Individual Consideration, pend to MED with comments regarding your procedure code.
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| What are the 3 special non-par provider numbers that will replace CHFEP and their type of service rendered? (Performing Provider only) | show 🗑
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