Processing Claims

Question 1

When you create a demand claim. Resolute automatically accepts it and marks its invoice status as

Answer 1

Accepted rather than process

Question 2

True or False: PB Demand claims are not checked for errors by the CDF

Answer 2

True

Question 3

The demand claim reprint function can only be performed on invoices/charge transactions on invoices with a status(s) of:

Answer 3

Processed/Accepted/Closed

Question 4

True or False: Reprinting an invoice prints out a new copy of the original invoice

Answer 4

True

Question 5

True or False: Cancel claims are sent to the payor to alert the payor that the previous claim had errors, and is followed by a new claim with corrected information

Answer 5

True

Question 6

True or False: A replacement claim are sent out the payor to replace a previous claim . Replacement claims can be produced for paper and electronic CMS claims

Answer 6

True

Question 7

A claim run that contains all Aetna charges is created. A 2nd claim run is created five minutes later that is also restricted to Aetna charges. What charges will be included in the second claim run?

Answer 7

Any charges with insurance balance due from Aetna and have been posted in the last 5 min.

Question 8

A Job indicates….

Answer 8

What you are doing, Also a template with mnemonics (prompts) and is configured of a “claims processing” template.

Question 9

A batch indicates….

Answer 9

One or more jobs grouped together.

Question 10

A run indicates…

Answer 10

When the task should be executed. The batch is plugged into the run

Question 11

True or False: A claim run can be accepted only if it has only been printed to paper or a file

Answer 11

True