Reopenings and Redeterminations
a year ago
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10 QuestionsShow answers
  • Question 1
    30 seconds
    Q.

    A reopening is a reprocessing of a claim to fix minor mistakes.

    answer choices

    True

    False

  • Question 2
    30 seconds
    Q.

    You will have as long as you want to submit a Redetermination.

    answer choices

    True

    False, you have 120 days from the claim determination.

  • Question 3
    30 seconds
    Q.

    A redetermination is an examination of a claim that includes analysis of documentation.

    answer choices

    True

    False

  • Question 4
    30 seconds
    Q.

    Modifiers 24, 25, 57, 58, 59, and 78 are some examples of Reopenings.

    answer choices

    True

    False

  • Question 5
    30 seconds
    Q.

    Modifiers 22, 52, 53 require claim documentation to avoid having to submit a redetermination.

    answer choices

    True

    False

  • Question 6
    30 seconds
    Q.

    When Medicare records are updated to show as primary payer, providers cannot reopen via Connex.

    answer choices

    True

    False

  • Question 7
    30 seconds
    Q.

    Are changing diagnosis codes redeterminations?

    answer choices

    Yes

    No

  • Question 8
    30 seconds
    Q.

    Would you reopen a claim to void line billed in error and resubmit a corrected claim?

    answer choices

    No, correct the initial claim.

    Yes

  • Question 9
    30 seconds
    Q.

    Are Modifiers GV and GW reopenings or redetermination

    answer choices

    Reopenings

    Redeterminations

  • Question 10
    30 seconds
    Q.

    When submitting a redetermination for repeat procedures, will you need to supply documentation on how many services were performed?

    answer choices

    Yes

    No

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