Claims Overview week one CI&W
Authored by jessica zalazar
Computers
1st - 5th Grade
Used 5+ times
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32 questions
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1.
MULTIPLE SELECT QUESTION
1 min • 1 pt
If you identify there has been fraud or PHI has been breached what should you do? choose all options below that apply
inform OE/Manager
Report to compliance
Do nothing
file a fraud report
2.
MULTIPLE SELECT QUESTION
1 min • 1 pt
What Anthem products will you encounter ( choose all that apply
PPO
CDHP
HMO
EPO
POS-Tier Plans
3.
MULTIPLE SELECT QUESTION
1 min • 1 pt
What options below are considered Cost Shares? Choose all that applies
Deductibles
Copay
Co-insurance
OOP/Stop loss
Benefit year
4.
MULTIPLE SELECT QUESTION
1 min • 1 pt
In CI&W dashboard you will be able to access your worklist( claims that have been assigned for you to work on)
False
True
5.
MULTIPLE CHOICE QUESTION
1 min • 1 pt
True or False, The system then routes the claim to a queue for processing based on claim data and group/contract information. If a claim is error free, it is adjudicated by the WGS system without human intervention, while others require manual processing
True
False
6.
MULTIPLE CHOICE QUESTION
1 min • 1 pt
which claim type below is a professional Claim?
IA
PO
PA
MA
7.
MULTIPLE SELECT QUESTION
1 min • 1 pt
What are the three parts to a Queue?
DX code
Unit Code
Function Code
Claim Code
Statues code
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