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AR Quiz Bowl! Flashcards | StudBud
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AR Quiz Bowl!
AR Quiz Bowl!
56 terms
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StudBud Administration
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12 plays
Find out where your strengths and opportunities are to hone your AR skills!
Flashcards
56 cards
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Practice quiz
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Host live
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Questions
56
Answers
1
What type of adjustment is a Write-Off/Balance Uncollect Adjustment?
Collections
Production
2
How often should the Payment Agreement Report be worked?
Weekly
Monthly
Daily
Quarterly
3
Insurance paid less than we expected. Which is NOT a step we need to take next?
Adjust off the remaining unexpected balance
Document why the payment was different
Update the coverage table %
Contact the patient about the balance created
4
What happens to an electronic attachment when the payor ID is set to 06126
It has to have an 8-digit date
It is dropped from the claim and never sent
The clearinghouse drops it to paper for us
It is sent electronically to the insurance company
5
An e-claims error says Subscriber ID is not found. How do you submit this claim?
Change the ID to the SSN and mail the claim
Change the ID to the SSN and e-send the claim
Zero out the claim and bill the patient
Find the correct ID # or call the pt and then resubmit
6
What code is posted to the ledger when you post an insurance check & it creates a true credit?
ALTLR
D0097
D0098
ARRVW
7
When can we take a pre-payment on Care Credit?
If the patient is scheduled within 30 days
If the patient wishes to pre-pay with Care Credit
If the patient only wants one bill from Care Credit
If the patient signs the receipt & we verify identification
8
You call on a claim & find out a check was sent to another office but NOT cashed. What now?
90 days after issue date, send Robin missing check request
Ask the insurance company to send a change of address form
Send Robin a missing check request form ASAP
Have the check reissued right away
9
What type of adjustment is a Misc Credit Adjustment?
Collections
Production
10
On One-Click Submit, what is the best way to honor our patient's stated monthly budget amount?
Budget Tool
My Smile Care
Care Credit website
Calculator
11
Why do we post an ortho check as an insurance payment and not inside the claim?
To keep track of how many ortho accounts we have in-office
To keep the claim open to follow up if payment is missed
To keep from applying it to the pt's regular insurance max
To make the ledger confusing and complicated
12
When reversing a pre-pay, what adjustment do you use to reverse the FP adjustment?
Payment debit adjustment
You do not reverse the FP adjustment, only the pre-pay
Misc credit adjustment
Misc debit adjustment
13
What is Thrive for % Over 90 Insurance?
10%
5%
6%
4%
14
Which of the following is NOT one of the 3 AR Reports run nightly?
Claims to Process
Secondary Claims not Created
Payment Agreement Report
Procedures Not Attached to Insurance
15
What fee schedule do you attach if a doctor is Delta Premier only?
Office Fee Schedule
Delta Plus Fee Schedule
Delta Fee Schedule
No fee schedule
16
What are steps 5, 6 and 7 of the SRS?
Specialty follow-up, Lab cases & Pre-auths, Smile Blast
Pts 2-3 weeks out, Specialty F/U, Lab cases & Pre-auths
Inform the team, Pts in chair, Pts in reception area
Lab cases & Pre-auths, Smile Blast, Work reports
17
What percentage of adjustments can be prevented?
60%
80%
5%
100%
18
Which is NOT a reason we change the claim format to 2012 during credentialing?
To send the PPO fee only to insurance
To charge the patient only the PPO copay
The claim will not process otherwise
To avoid being overpaid
19
Which is NOT a main component of VOI Simplify?
Correct the coverage table as you post checks
Fill out a VOI Simplify form and scan it into the doc center
Verify pt eligibility and insurance information
Check for the new default #1 coverage table
20
If our ledger fee is $150, what is the correct adjustment?
$70 insurance adjustment
$86 insurance adjustment
$44 insurance adjustment
$70 misc credit adjustment
21
What is the allowed amount on the following EOB?
$80
$64
$42
$106
22
An insurance rep gives you a payor ID not in our payor ID drop-down menu. What should you do?
Change the payor ID to 06126 (all other payors)
Use the payor ID search on the intranet to verify
Flag the account that claims must be mailed
Type the payor ID given to you in the payor ID box
23
A signed financial policy is required to send a patient to collections.
False
True
24
For what reason do we update the coverage table to the new default #1?
Accurate and conservative treatment plans
All of the above
Fewer statements sent and calls to make
The newest ADA codes are added
25
Credentialing states to change the claim format prior to sending claims for Metlife. Why?
Because Support Office likes to torment us
So Metlife knows we are going through credentialing
So Metlife will pay based on our PPO fee, not on full fee
So that if Metlife overpays, we know to debit up & keep it
26
We make a courtesy call for all patients with a balance over _________ days with no payment.
60
120
90
30
27
Which of the following is a preventable adjustment?
Insurance adjustments
Primary/Secondary Adjustments
FP Adjustments
Delta Premier Adjustments
28
When we post an ortho insurance payment, why do we need to update benefits used?
To check on any missed handshake payments
So we know how much insurance owes and what pt balance is
So we know we have the correct insurance in the family file
To verify the patient is paying their portion
29
What type of adjustment is a Payment Debit Adjustment?
Collections
Production
30
Which is NOT a step in the non-delivered process?
Submit non-delivered request on Request Home Office Support
Continually call the patient to try and schedule delivery
Send certified letter with follow-up date in 10-15 days
Call patient 2 x within 30 days of receipt of appliance
31
What is the Thrive value for Over 60 patient aging %?
5%
10%
16%
20%
32
How do you best use the Courtesy Call spreadsheet to diagnose what's missing in your office?
Give it to a BA to work ASAP
Look at accounts with balances & no call in the last 30 days
Divide the list up and call all accounts
Look at all accounts with balances shown
33
When does an office use the adjustment "Write Off/Balance Uncollect"?
When we write off balances out of courtesy
When we write off balances under $10
When the patient doesn't have another appointment scheduled
Never, only Support Office uses this adjustment
34
Insurance overpays due to credentialing. We debit up the difference so a credit isn't created.
False
True
35
What is the easiest thing we can do to prevent account audits?
Write good notes when posting checks
Split family members onto their own accounts
Verify insurance
Collect DOS
36
Can you look up a new patient's insurance benefits using E-Services?
No
Yes
37
What is the most common reason for having to make an insurance adjustment when posting?
Incorrect Group Number
Incorrect Fee Schedule
Incorrect Estimated Amount
Incorrect Payor ID
38
For crown week, how do you note the claim we are giving $200 off each crown? (G5 or G6)
Change the claim format to 2012, then note the claim
Change the ledger fee, then note the claim with the discount
Note the claim with "not usual and customary fees"
Send full fees, note the claim the patient received $200 off
39
Why do we create a separate ortho insurance plan for an ortho account?
For tracking purposes
To keep track of insurance plans that have ortho benefits
Ortho benefits and max may be different from the regular ins
So we know how many ortho accounts we have in-office
40
What is Thrive for % Over 90 Patient Aging?
8%
14%
5%
20%
41
What accounts appear on the Over 180 Report
Accounts with balances but no activity in over 3 months
Accounts with balances but no activity in over 6 months
Accounts that have not received a statement in 6 months
Ortho balances over 6 months with periodic ortho visits
42
Dr. does a crown on a friend & wants to collect ONLY what ins pays. How do we handle the claim?
We can't charge ins if we don't charge the pt - so no claim!
We send a letter to insurance explaining the situation
We note the claim the patient received a discount
We tell the patient he will have no copay
43
What is required to check when approving adjustments over $250?
All of the above
What caused the adjustment was fixed
Adjustment for the correct amount
Adjustment to the correct provider
44
What type of adjustment is a FP Adjustment?
Collections
Production
45
Where on the Intranet can you find all of the support personnel for your office?
Homeroom
Office Directory
PMO Manual
AR Playbook
46
Does a D0097 courtesy call posted to the ledger of an Over 180 account qualify as "activity"?
No
Yes
47
On a patient ledger, you see an insurance adjustment on every claim. What's your first thought?
Fee schedule is incorrect
Treatment plan was not updated
Somebody can't do math
We are out of network
48
When posting the pt's copay, select the provider they saw today and post the payment to them.
False
True
49
Why do we call patients with balances over 30 days?
Because the PMO said so
To bond with our patients
To increase our chances of collecting the balance
Because Support Office says so
50
Our MetLife PPO fee is $43. Metlife pays $100 and states they allow $100. What do you do?
Void the check and send a corrected claim
Stuff this check on the bottom of the pile for someone else
Post $100 and do a debit adjustment for $57
Call MetLife to find out why they processed out of network
51
The purpose of working the insurance aging report is
To give our BAs something to do
To make sure the patient is eligible for benefits
To look online if a claim is on file with insurance
To find out why a claim hasn't been paid and get it paid
52
We call on all claims over ___________ days old that have not been paid.
30
90
120
60
53
Which is a reason to update treatment plan fees.
Prior to presenting a tx plan to a new patient
All of the above
Patient changed insurance companies
Treatment plan is over 30 days old
54
Why is it important to work zero pays before posting checks?
A zero pay is $$$ that won't be paid unless action is taken
Zero pays self-destruct in 30 days
55
When a patient pays off a collections balance in the office, what do you need to do?
Post payment, call the Collections Team at Support Office
We cannot accept payment on a collections account in-office
Post payment, call Robin to reverse the collections adj
Post payment, reverse adj, & call the collections agency
56
How do you determine if the new default coverage table is attached to a patient's family file?
Arestin comes up as zero
The PPO fees will come up in the ledger
It says "1" in the coverage table box
The code D4346 is split out
