Blue Cross/Blue Shield - Questions w/ Answers with correct answers 100%

Blue Cross/Blue Shield - Questions w/ Answers with correct answers 100% What is a timely filling requirement? - Correct Answer The time frame a provider has to submit a claim. A______is correspondence sent from the insurance payer to the patient after they receive healthcare services to explain the status of a claim. - Correct Answer Explanation of Benefits (EOB) Based on the Explanation of Benefits example below, what is the amount that is adjusted off by the provider? - Correct Answer $6.00 Which of the following is NOT a data entry denial? - Correct Answer Coverage terminated Review the insurance card: What is the group number from the example insurance card ? - Correct Answer 123456 What is the copayment amount the patient will pay to go to the emergency department in the example above? - Correct Answer $100.00 What does a participating provider agree to when signing a contract with an insurance payer? - Correct Answer The provider wishes to participate and agrees to accept the fee schedules set by that specific insurance. Which of the following type of insurance allows members to choose medical services as needed and can go in or out of network? - Correct Answer POS Which is a reimbursement plan that is funded by employers? - Correct Answer HRA What role does an Insurance Provider Representative play? - Correct Answer The liaison between the insurance payer and the provide