Scenario Based Quiz - Claim in process

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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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18 comments:

  1. Anonymous25 October 2023 at 00:48

    TAT means?

    ReplyDelete
  2. Anonymous16 January 2024 at 13:39

    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

    ReplyDelete
    Replies
    1. ARLearning Team21 January 2024 at 01:57

      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?

      Delete
    2. Anonymous22 January 2024 at 12:55

      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

      Delete
    3. ARLearning Team4 February 2024 at 06:11

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

      Thanks for your comment.

      Delete
    4. Anonymous22 June 2024 at 18:04

      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....

      Delete
  3. Anonymous25 March 2024 at 03:44

    Where can I get correct answer for the test questions

    ReplyDelete
    Replies
    1. ARLearning Team1 April 2024 at 08:22

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

      Delete
  4. Anonymous26 April 2024 at 03:09

    POTF means

    ReplyDelete
  5. Anonymous31 July 2024 at 11:16

    I have a doubt on 8th quetion the ans should be 4th option non of the above bcz the letter was not set to the patient so why to bill patient

    ReplyDelete
    Replies
    1. ARLearning Team11 August 2024 at 09:50

      What if the letter will never be sent, you can't keep the claim in process that will exhaust the TFL. Instead, you can release the claim to the patient with the reason and the patient can provide more details after taking the follow-up with insurance. This will help to move the claim to the resolution.

      Delete
  6. Anonymous11 October 2024 at 10:56

    I Scored 10/10 .......very useful to Trainee

    ReplyDelete
  7. Anonymous30 December 2024 at 09:59

    You are doing commendable work!

    ReplyDelete