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Module 6 - CST Review

Quiz by Jayda Leritz

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16 questions
Show answers
  • Q1
    What information will you need to locate a claim without using a claim number?
    Question Image
    Business Tax ID and/or Subscriber ID number with a date range.
    Business Tax ID and/or Third Party Agency Tax ID with a date range.
    30s
  • Q2
    On a procedure screen of a claim, there are how many sections?
    6
    5
    4
    7
    30s
  • Q3
    Using the image, what does the missing information indicate?
    Question Image
    Out of country claims
    Pre-Treatment Estimate
    30s
  • Q4
    What is the difference between "Adjust Claim" and "Reverse Claim"?
    Question Image
    Adjust claim allows you to edit the submitted claim, while reverse claim removes the submitted claim from our system.
    Adjust claim removes the claim out of our system and reverse claim changes how the claim is submitted in our system.
    30s
  • Q5
    What is the dollar threshold that causes a claim to route into a "Corporate Audit" review?
    Question Image
    $3000
    $1500
    $2500
    $2,000
    30s
  • Q6
    Which of the following is a reason to "Adjust a Claim"?
    Question Image
    All of the above
    incorrect patient
    incorrect provider
    incorrect tooth
    30s
  • Q7
    What is the benefit of using the "Family Claims History" button vs "Claims History" button on your benefits screen?
    Question Image
    To access all claims related to the subscriber's account, including dependents.
    To access claims for the subscriber only.
    30s
  • Q8
    In the claim procedure section, how do you know that a claim has been adjusted?
    An extra action button appears, thats blue text, at the top of the screen.
    A message will appear in the middle of your screen indicating the claim has been adjusted.
    30s
  • Q9
    Pre-Treatment estimates are similar to a processed claim but can the Pre-Treatment estimate be adjusted?
    Yes
    No
    30s
  • Q10
    What is a claim called when the claim is not attached to a members policy?
    dolphin
    invalid claim
    orphan
    no special name
    30s
  • Q11
    Looking at the claims Inquiry "advanced search" section, what does the ICN mean?
    Question Image
    internal control number
    internal connection number
    internal claim number
    Individual control number
    30s
  • Q12
    Looking at the claims Inquiry screen "advanced search" section, what does "XCN" mean?
    external control number
    exhibit control number
    extra control number
    external claim number
    30s
  • Q13
    When you see the "C.O.B" action button at the top of a claim, what does it indicate?
    Question Image
    There is coordination of benefits for this claim
    The plan allows COB
    All of the above
    There is collection of benefits for this claim
    30s
  • Q14
    What does the reverse claim button do?
    Question Image
    It reverses the entire claim submitted inadvertently in order to clear history for the patient or COB issues
    It processes a claim adjustment.
    30s
  • Q15
    A Pre-Estimate was submitted at the end of a benefit year but services were not completed. Which button will allow you to fix the claim issue for our provider?
    Adjust Claim
    Reverse Claim
    Re-Add Claim
    30s

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