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1. What is the 1st step concerning a denial for no auth?
A
Check pt's SSN.
B
Find out if the service requires an auth.
C
Run pt's insurance thru RTE.
2. Where can you find medical policies for our managed care payors?
A
Smartsheet
B
Managed Care Website.
C
Referral tab.
3. When working a no auth denial, don't assume
A
that pt is not active for this dos.
B
that provider is provider is exempt from auth.
C
that it is a credentialing issue.
4. Some payors require pt to select a PCP. You can find this info
A
on the Smartsheet.
B
Under summary tab.
C
on pt's insurance card.
5. When looking at the claim image, auths will be listed
A
auth will not be listed on claim.
B
in box 17.
C
in box 23.
6. T/F - Sometimes practices can get an auth, but not attach it to the claim.
A
N/A
B
F
C
T
7. In order to add an existing auth to be added to a claim,
A
you must email Laura first.
B
there must be a blue checkmark next to it.
C
there must be a red checkmark next to it.
8. Where are other places you can look for auths?
A
Pt's registration, summary tab.
B
Pt's chart, summary tab
C
Pt's chart, referrals tab
9. Not all services with a __________ need an auth.
A
59 modifier
B
TC modifier
C
26 modifier
10. When services billed on the claim are slightly different than what was authorized, we should
A
write- off the claim, services must match what was authorized.
B
Send an email to Sandy.
C
appeal using letter template on Managed Care website.
11. Where can you find the auth denials and referrals visio?
A
In pt's chart.
B
In the TEAMs file and on the Authorization Power Point.
C
On the Smart sheet.