OOS PRS Claims Review

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Across
  1. 4. The UB04 form is used by these providers
  2. 5. The CMS1500 form is used by these providers
  3. 9. Payment Recovery Specialists are part of the Billing and ____________ Team in OOS
  4. 11. Explanation from a payor to a provider about a claim payment
  5. 12. Software program enabling users to submit claims electronically and access insurance eligibility information
  6. 13. Payment Recovery Specialists obtain claim status via web portal or via _________
Down
  1. 1. The Explanation of _________ (EOB) is a letter sent to the insured individual after a claim for payment has been processed by the payor
  2. 2. One option to explore when a claim has been denied
  3. 3. Account Reimbursement __________ are responsible for submitting appeals
  4. 6. Claim status when it has been received but has not been paid or denied
  5. 7. The Internal __________ Number (ICN) is a unique identification number assigned to each claim to track and process payment for services
  6. 8. An Interactive ________ Response (IVR) system allows callers to access information via a system of pre-recorded messages
  7. 10. The National __________ Identifier (NPI) is a unique number assigned to covered health care providers