Scenario Based Quiz

• Claim not on file
• Claim in process
• Approved to pay
• Claim paid
• Claim paid & applied towards offset
• Claim paid to patient
• Claim applied towards deductible
• Patient cannot be identified
• Coverage terminated
• TFL Expired
• Authorization absent or missing
• Referral is absent or missing
• Maximum benefit exhausted/reached
• Non covered charges
• Non covered charges as provider is out of network
• Additional information requested from patient
• Globally inclusive to surgery/Globally inclusive
• Patient enrolled in hospice
• Primary paid more than secondary allowed amount
• Duplicate Service
• Capitation Agreement / Managed Care Plan

Modifier Based Quiz

• Part - 1
• Part - 2
  
  

Interview Questions

• Part - 1