Institutional Claim

Created by alyssajuda

20191204I000024

  1.  
    What claim form did the provider utilize to submit this?
    A. CMS-1500 B. UB-04 C. Medical Claim Form D. What the office uses
  2.  
    Why was the member at Park Nicollet Methodist Hospital?
  3.  
    Use SmartData. What is the address of the facility visited?
  4.  
    Use help.yourbind.com. What is the copay for Delivery at Park Nicollet Methodist Hospital?
    A. $1,500 B. $1,000 C. $100 D. $500
  5.  
    How much did the facility bill? How much did we pay the provider?
  6.  
    Look at the notes on this claim. When was this adjusted and why?
  7.  
    What network priced this claim?
Answer Key
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Institutional Claim (Answer Key)

Created by alyssajuda

20191204I000024

  1.  
    What claim form did the provider utilize to submit this?
    A. CMS-1500 B. UB-04 C. Medical Claim Form D. What the office uses
  2.  
    Why was the member at Park Nicollet Methodist Hospital?
    Maternity Delivery Care
  3.  
    Use SmartData. What is the address of the facility visited?
    6500 Excelsior Blvd St Louis Park, MN 55426
  4.  
    Use help.yourbind.com. What is the copay for Delivery at Park Nicollet Methodist Hospital?
    A. $1,500 B. $1,000 C. $100 D. $500
  5.  
    How much did the facility bill? How much did we pay the provider?
    $8,972.85 - facility. $5,397.00 - insurance paid
  6.  
    Look at the notes on this claim. When was this adjusted and why?
    Adjusted on 12/4, because it was processed with $1,500 copay instead of $500 smart copay
  7.  
    What network priced this claim?
    United Healthcare

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