Scenario Based Quiz - TFL Expired

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1. If you receive the status on call as the claim is denied as TFL has expired then what will be your next valid questions? May I get the denial date?
When did you receive the claim?
How much is the Timely filing limit?
None of the above
Click here to go on TFL scenario

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2. If you receive the status on call as the claim is denied as TFL has expired but the claim was received within TFL then what will be your next question? Could you please send the claim back for reprocessing since the claim was received within TFL?
Can we appeal with POTF?
What is the fax# or Mailing address to send an appeal?
All of the above
Click here to go on TFL scenario

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3. If you receive the status on call as the claim is denied as TFL has expired and the claim was received after TFL and the POTF is available then what will be your next questions? Can we appeal with POTF?
What is the fax# or Mailing address to send an appeal? & What is the appeal limit?
May I have the claim# & call ref#?
All of the above
Click here to go on TFL scenario

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4. If the claim is denied for TFL expired incorrectly and the rep sends the claim back for reprocessing then what will be your action? Send an appeal to the insurance
Set the follow-up for the TAT
Write off the claim
None of the above
Click here to go on TFL scenario

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5. If the claim is denied for TFL has expired and the claim was received by the insurance after the TFL period crossed and you do have the POTF and the rep confirms that you can appeal with POTF then what will be your action? Send an appeal to the insurance
Set the follow-up for the TAT
Write off the claim
None of the above
Click here to go on TFL scenario

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6. If the claim is denied for TFL has expired and the claim was received by the insurance after TFL period crossed and there is no POTF what will be your action? Send an appeal to the insurance
Set the follow-up for the TAT
Write off the claim
None of the above
Click here to go on TFL scenario

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7. TFL must be calculated from? Date of service (DOS)
Received date
Date of denial (DOD)
None of the above
Click here to go on TFL scenario

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8. Which of the following option cannot be considered as POTF? An initial filed claim to the same insurance which is not received by the payer
Initially rejected claims
TFL denial EOB
Initial billing to any other payer
Click here to go on TFL scenario

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9. Appeal filing limit (AFL) must be calculated from? Date of service (DOS)
Received date
Date of denial (DOD)
None of the above
Click here to go on TFL scenario

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10. If the claim has DOS as 01/25/2023 and TFL is 120 days and the claim was received by the insurance on 05/25/2023 then should the claim be denied for TFL expired? Yes
No
Click here to go on TFL scenario

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