Claims Training

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

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