Scenario Based Quiz - Claim paid & applied towards offset

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1. What is the reason for the claim paid and applied towards offset? The provider is out-of-network?
An additional amount paid to the patient in the past
An additional amount paid to the provider in the past
AOB is not signed by the patient
Click here to go on offset scenario

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2. If the claim is applied towards offset and paid details are correct then what will be your next questions? May I know the reason, why is it applied towards offset?
May I know to which patient is it applied towards offset?
May I know the patient account#, DOS & CPT?
All of the above
Click here to go on offset scenario

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3. If the claim is paid and applied towards offset but the payment details are not correct i.e. the paid amount and PTR are not equal to the allowed amount then what will you do? Ask for clarification from the rep
Ask to fax or mail the EOB
Ask for patient details to which it is applied towards offset
None of the above
Click here to go on offset scenario

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4. If the claim is paid and applied towards offset and you get all the details and receive the EOB then what will be action? Note the account
Note the account and send the EOB for posting
Set the follow-up for TAT provided by the rep
None of the above
Click here to go on offset scenario

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5. If the claim is paid and applied towards offset and you get all the details and requested the EOB but do not receive the EOB then what will be your action? Note the account
Note the account and send the EOB for posting
Set the follow-up for TAT provided by the rep
None of the above
Click here to go on offset scenario

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