Training Review

4. any event affecting a FEP Member involving an accidental injury
6. caused by an external force or element, such as a blow or fall that requires immediate medical attention including animal bites
7. equipment designed for repeated use and which is medically necessary for the treatment of an illness or injury, to improve the function of a body’s malformation, or to prevent further deterioration of the patient’s medical condition.
12. is the use of drugs and medications to treat an illness, injury, or set of symptoms.
15. The HCFA form is for what kind of charges?
16. Place of service 20
17. type of rep that has access to specific information based on the member’s request
18. What is the UB form for?
19. the contractual requirement of the member to contact the Local Plan where the services will be performed, before being admitted to a hospital for inpatient care, or within two business days following the admission when the hospital admission is an emergency
20. Facilities bill using these kind of codes

1. What policy do we follow if we receive a claim for a potential subrogation or worker’s comp claim?
2. Enrollment Codes 104, 105, and 106
3. Dental claim form
5. What does a disposition code of 4 mean?
8. an internet based application that is used when a stop payment/reissue has been requested on the original check
9. Preferred facilities used to perform specific facility-based surgical procedures and transplants.
10. covered for a Member under active treatment for a metabolic or peripheral vascular disease, such as diabetes
11. the general term used by the insurance industry to describe situations where the financial responsibility for a Member’s medical expenses rests (in whole or in part) with another carrier
13. are used to further identify the procedure performed
14. system used to find DME files