Scenario Based Quiz - Claim in process


1. If the claim is in process and the claim has crossed the TAT then what will be your next question?





2. If the claim is in process and the claim has crossed the TAT and the delayed reason is provided as an additional document requested from the provider then what will be your next questions?





3. If the claim is in process and the claim has crossed the TAT and the delayed reason is provided as an additional document requested from the patient then what will be your next question?





4. If the claim is in process and the claim has crossed the TAT and the delayed reason is provided as an additional document requested from the patient and a letter is also sent to the patient then what will be your next question?





5. If the claim is in process and the claim is within the TAT then what will be your action?





6. If the claim is in process for the delayed reason as an additional document was requested from the provider and you have the document and authority to send the document then what will be your action?





7. If the claim is in process for the delayed reason as an additional document requested from the provider and you do not have the document then what will be your action?





8. If the claim is in process for the delayed reason as additional information was requested from the patient and a letter is not sent to the patient then what will be your action?





9. If the claim is in process for the delayed reason as additional information was requested from the patient and a letter is sent to the patient but the letter sent date has not crossed 1 month then what will be your action?





10. If the claim is in process for the delayed reason as additional information was requested from the patient and a letter is sent to the patient and the letter sent date has crossed 1 month then what will be your action?









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11 comments:

  1. Hi this is Mansoor. I have doubt here. In the question number 4 the correct answer is given as option 1 but it should be 3. Can you please check and let me know what is the correct one. Thank you

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    Replies
    1. For question 4, 1st option is correct. Because, if the additional information is requested from the patient and a letter is sent to the patient then why will you ask for "What document requested" from the rep?

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    2. But we also should know what documents they require. If we have the documents what they need then we can send those to the insurance. Thank you

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    3. Yes, you are right. There is a possibility of this option. We will update the scenario and quiz.

      Thanks for your comment.

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    4. The question was great there is no need of adjustments in it just that as per the scenario as letters were sent and the next questions that we should ask would be when was the letter sent then comes the question has the patient responded to the letter and as per which document required is not needed as it's needed from patient's side.
      Otherwise it's fun to work on these scenarios....

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  2. Where can I get correct answer for the test questions

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    Replies
    1. You can try all the options one by one to find the correct answer.

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