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Claims Training
Procedures
Instructions:
-
If claim is received with no Drivers Name, how would you proceed?
A. Skip the claims.
B. Pay the claims
C. Gain needed information from the previous/next page
D. Select the (Driver Not in System) option for sub-batch.
E. Deny on paper only for MDI/MDNS
-
If claim is listed as cancelled in Insight, how would you proceed?
A. Skip the claim.
B. Process and pay.
C. Deny for UNS (unauthorized no-show).
D. Process and deny claim for SNPM
-
If claim was submitted with the incorrect Leg ID# listed, how would you proceed?
A. Deny in Insight for ITI.
B. Search for the correct Leg ID#.
C. Deny on paper for ITI
D. Deny on paper for MCN.
E. Deny in Insight for MCN.
-
If you receive the error message "Driver is not valid for the entirety of the trip", what would you deny for?
A. MDNS
B. MDI
C. ALD
D. CD
E. UAD
-
If provider has not listed the SETI Decal or License Plate#, what would you deny for?
A. MPN
B. IMT
C. MER
D. MLP
E. MEN
-
If the mobility type circled does not match what is listed in Insight, what would you deny the claim for?
A. IMT
B. MMO
C. MCO
D. UAV
E. SDV
-
If claim is submitted with "Stretcher" mobility type, what else must be listed on the claim form?
A. Member Name
B. Leg ID#
C. Initials
D. Attendant/Monitor
E. Provider Comments
Claims Training
(Answer Key)
Procedures
Instructions:
-
If claim is received with no Drivers Name, how would you proceed?
A. Skip the claims.
B. Pay the claims
C. Gain needed information from the previous/next page
D. Select the (Driver Not in System) option for sub-batch.
E. Deny on paper only for MDI/MDNS
-
If claim is listed as cancelled in Insight, how would you proceed?
A. Skip the claim.
B. Process and pay.
C. Deny for UNS (unauthorized no-show).
D. Process and deny claim for SNPM
-
If claim was submitted with the incorrect Leg ID# listed, how would you proceed?
A. Deny in Insight for ITI.
B. Search for the correct Leg ID#.
C. Deny on paper for ITI
D. Deny on paper for MCN.
E. Deny in Insight for MCN.
-
If you receive the error message "Driver is not valid for the entirety of the trip", what would you deny for?
A. MDNS
B. MDI
C. ALD
D. CD
E. UAD
-
If provider has not listed the SETI Decal or License Plate#, what would you deny for?
A. MPN
B. IMT
C. MER
D. MLP
E. MEN
-
If the mobility type circled does not match what is listed in Insight, what would you deny the claim for?
A. IMT
B. MMO
C. MCO
D. UAV
E. SDV
-
If claim is submitted with "Stretcher" mobility type, what else must be listed on the claim form?
A. Member Name
B. Leg ID#
C. Initials
D. Attendant/Monitor
E. Provider Comments