Scenario Based Quiz - Duplicate Service

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1. If you receive the status on call as the claim is denied for duplicate service and when you check in the system then you find that the same CPT is billed more than once on DOS and rendering providers on both the charges are different and the rep agrees to reprocess the claim on probing then what will be your next valid question? What is the Fax# or Mailing address to send an appeal?
What is the TAT for reprocessing?
What is the time frame for corrected claim?
What is the original status of the claim?
Click here to go on Duplicate scenario

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2. If the claim is denied by non-Medicare insurance for duplicate service and when you check in the system you find that the same CPT is billed more than once on DOS and rendering providers on both the charges are the same but the exam times are different then what will be your action? Update the 76 modifier and resubmit the claim
Update the 77 modifier and resubmit the claim
Update the 76 modifier and submit the corrected claim
Update the 77 modifier and submit the corrected claim
Click here to go on Duplicate scenario

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3. If you receive the status on call as the claim is denied for duplicate service and when you check in the system then you find that the same CPT is billed more than once on DOS and rendering providers on both the charges are different but the rep denies to reprocess the claim and ask to send the corrected claim then what will be your next valid question? Can you please reprocess the claim since modifier, rendering provider or exam time on medical records are different?
What is the TAT for reprocessing?
What is the time frame for corrected claim?
What is the original status of the claim?
Click here to go on Duplicate scenario

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4. If the claim is denied by Medicare insurance for duplicate service and when you check in the system you find that the same CPT is billed more than once on DOS and rendering providers on both the charges are different then what will be your action? Update the 76 modifier and resubmit the claim
Update the 77 modifier and resubmit the claim
Update the 76 modifier and submit the corrected claim
Update the 77 modifier and submit the corrected claim
Click here to go on Duplicate scenario

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5. If you receive the status on call as the claim is denied for duplicate service and when you check in the system then you find that the same CPT is billed more than once on DOS and modifiers on both the charges are different and the rep denies to reprocess the claim and ask to send an appeal then what will be your next valid questions? Can you please reprocess the claim since modifier, rendering provider or exam time on medical records are different?
What is the TAT for reprocessing?
What is the Fax# or Mailing address to send an appeal?
How much is the time limit?
Click here to go on Duplicate scenario

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6. If the claim is denied by non-Medicare insurance for duplicate service and when you check in the system you find that the same CPT is billed more than once on DOS and rendering providers on both the charges are different then what will be your action? Update the 76 modifier and resubmit the claim
Update the 77 modifier and resubmit the claim
Update the 76 modifier and submit the corrected claim
Update the 77 modifier and submit the corrected claim
Click here to go on Duplicate scenario

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7. If you receive the status on call as the claim is denied for duplicate service and when you check in the system then you find that the CPT is billed once only on DOS then what will be your next valid question? Can you please reprocess the claim since modifier, rendering provider or exam time on medical records are different?
What is the TAT for reprocessing?
What is the time frame for corrected claim?
What is the original status of the claim?
Click here to go on Duplicate scenario

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8. If the claim is denied by Medicare insurance for duplicate service and when you check in the system you find that the same CPT is billed more than once on DOS and rendering providers on both the charges are the same but the exam time are different then what will be your action? Update the 76 modifier and resubmit the claim
Update the 77 modifier and resubmit the claim
Update the 76 modifier and submit the corrected claim
Update the 77 modifier and submit the corrected claim
Click here to go on Duplicate scenario

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9. If the claim is denied by Medicare insurance for duplicate service and when you check in the system you find that the same CPT is billed more than once on DOS and both are exact duplicates then what will be your action? Update the 76 modifier and resubmit the claim
Update the 77 modifier and resubmit the claim
Void the claim
None of the above
Click here to go on Duplicate scenario

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10. If the claim is denied by the insurance for duplicate service and when you check in the system you find that the same CPT is billed more than once on DOS and rendering providers on both the charges are different but the time frame to submit the corrected claim has been crossed then what will be your action? Write off the claim
Update the 76 modifier and submit the corrected claim
Update the 77 modifier and submit the corrected claim
None of the above
Click here to go on Duplicate scenario

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11. What are the possible reasons for the claim to be denied as Duplicate service? A service is billed more than once on the same date of service
A claim is billed twice in an error
A claim is billed after TFL expires
The AOB is not signed by the patient
Click here to go on Duplicate scenario

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12. If the claim is denied by the insurance for duplicate service and when you check in the system you find that the same CPT is billed more than once on DOS but the modifiers on both the charges are different and the rep denies to reprocess the claim and asked to send an appeal then what will be your action? Submit the corrected claim
Send an appeal to the insurance
Void the claim
None of the above
Click here to go on Duplicate scenario

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13. If you receive the status on call as the claim is denied for duplicate service and when you check in the system then you find that the CPT is billed once only on DOS and the rep provides the original status as the claim is paid to the provider then what will be your next step? Will send the corrected claim to the insurance
Will send an appeal to the insurance
Will ask to reprocess the claim
Will follow paid-to-provider scenario
Click here to go on Duplicate scenario

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14. If the claim is denied by the insurance for duplicate service and when you check in the system you find that the same CPT is billed more than once on DOS but the modifiers on both the charges are different but the rep denies to reprocess the claim and asked to send an appeal and the time frame to send an appeal has been crossed then what will be your action? Resubmit the claim to insurance
Send an appeal to the insurance
Write off the claim
None of the above
Click here to go on Duplicate scenario

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15. If you receive the status on call as the claim is denied for duplicate service and when you check in the system then you find that the same CPT is billed more than once on DOS and rendering providers on both charges are different then what will be your next valid question? Can you please reprocess the claim since rendering providers are different?
What is the Fax# or Mailing address to send an appeal?
How much is the time limit?
What is the original status of the claim?
Click here to go on Duplicate scenario

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