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- 1. Multiple Choice
Upon receipt of the 277 Claims Acknowledgement transaction, your claim edits in EDI front-end processing system because the claim is a duplicate.
Access self-service portal to review history of claim submission and submit or correct claim that was initially submitted.
Do nothing.
- 2. Multiple Choice
You don’t know the difference between a Reopening and a Redetermination.
Access www.ngsmedicare.com > Claims & Appeals > Reopening versus Redetermination
Call PCC
- 3. Multiple Choice
Before submitting claims to NGSMedicare, providers shall check beneficiary’s Medicare eligibility:
True
False
- 4. Multiple Choice
To reduce burden and to avoid unnecessary Redeterminations when submitting claims with modifiers 22, 52, or 53, provider should be set up to submit electronic claims with electronic attachment program.
True
False
- 5. Multiple Choice
Your claim has rejected as unprocessable (MA130).
Review what was missing, incomplete, or invalid and resubmit a new claim
Submit a redetermination
- 6. Multiple Choice
Your appeal is beyond the timely filing and your reason does not fall under the exception?
Document your records to avoid extra unnecessary paper work
Submit an appeal anyway
- 7. Multiple Choice
The claim you submitted was submitted with a wrong procedure code, 99215 should have been billed as a 99213 and you recognize an overpayment.
Submit a reopening
Submit a redetermination
- 8. Multiple Choice
Choosing date of service (DOS) for physician services
Use the DOS to be used by physician will be same day in which beneficiary received face-to-face service
Use any DOS
- 9. Multiple Choice
Choosing a date of service (DOS) for diagnostic test, use the date of review and interpretation was completed or use the date of service (DOS) TC was performed
True
False
- 10. Multiple Choice
Your claim paid by Medicare and also by the Uniform Services Family Health Plan or VA.
Conduct a reopening to void the charges as an overpayment
Conduct a redetermination
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