Billing Issues July 12, 2020 admin Leave a comment Welcome to your Billing Issues 1. What is APA and when does an order need it? A. Is a form to be filled out informing insurance of the items consumer needs, so consumer can avail the discount from providers. B. A form to be filled out and send to providers so consumer can avail any items he needs without any costs. C. An auth/service order required if an order has waiver items included. 2. What do you do when APA is required for an order but is missing? A. There's no need to do anything, just pretend you don't know anything. B. Check the order if APA is actually needed and when it is send request to care manager or insurance. C. Pretend your upset and make complaints on these irregularities, there's a good chance you may get what you want. 3. How many days/how long before we received a response from insurance? A. After 45 days MSI should received a response from insurance. B. 30 days minimum waiting time. C. 6 months most likely 4. If MSI don't get any response from insurance after the expected time frame. What action should MSI take? A. Call them, nag and complain B. Research and investigate the possible reasons C. If No response from insurance after 45 days billers should review claim, there maybe underlying for it. D. B & C 5. What are the product categories consumer usually have? A. Supplements, Medicines, Emergency Kits B. Vitamins, Milk, Food supplies C. Incontinence, Nutrition, Catheters 6. What should billers do when there is no recipient EDI response within 6 months? 7. On rejected claims what should billers do? A. Billers should not bother to find out the reason why the claim was denied. B. Billers should check the reasons as to why the claim was denied. C. Don't waste your time investigating rejected claims it won't get paid whatever you do. 8. There are several reasons why claim didn't get paid. Which of the following is NOT TRUE? A. Diagnose issue B. They simply hate MSI and don't want to pay C. No claim was sent 9. When APA status box turns red. What does it mean? 10. When one comes across an issue of multiple APA. What should one do? A. Ignore it and carry on as long as there is a valid APA. B. Randomly choose an APA of your own choice C. Check the APA's they could be overlapping each other, one must be termed so the most updated one may be active. Time's up
