Unit 2 Vocab: VBA

4. Service area in VBA where claims and other work items can be routed to queues for specific people or teams to work on.
5. Codes used to pend, deny, or provide information about claims. These can be applied by the system or a Claims Examiner.
7. A button within the toolbar of a claim that has not auto-adjudicated and is not yet processed to reveal system-identified problems with the claim (i.e. the system may suspect the claim is a dupe. By clicking on the errors button, a message conveying the potential for a dupe is revealed).
8. The employee.
9. The process a Claims Examiner undergoes to process a claim that could not be auto-adjudicated.
12. Service area in VBA where authorizations are managed and can be researched.
13. Service area in VBA where claims are processed and can be researched.
16. Service area in VBA where benefit codes and plan benefits are managed and can be researched for deductibles and coinsurance rates.
17. The number assigned to a batch of claims that came in or were added to the system at the same time. Note: Batch Numbers are assigned before claims are processed.

1. The number assigned to a claim after it has been processed. Note: Processed claims will have a batch number, claim number, AND a finalized claim number.
2. Service area in VBA where members are managed and can be researched for eligibility and accumulations and ID cards can be requested at the member level.
3. A button within the toolbar of an unprocessed claim that can be clicked after all errors have been cleared to fully process the claim and push it towards funding.
6. Sections of VBA dedicated to specific functions. Service areas work in conjunction with and independent of other service areas.
10. The number assigned to a singular claim within that batch. Note: This type of claim number is assigned before a claim is processed.
11. A cloud-based claims processing platform.
14. Section of Claim Services where all processed claims are housed.
15. Dependents on the plan.