1.
Users must be able to identify the following information to load Primary coverage:
Correct Answer(s)
A. Subscriber
C. Carrier name
D. Carrier number
F. Effective date
G. Financial class
Explanation
To load Primary coverage, users need to identify specific information such as the subscriber's details, including their name, the carrier's name and number, the effective date of coverage, and the financial class. These details are essential for accurately recording and processing the primary coverage information in the system. The home phone number and expiration date are not mentioned as necessary information for loading Primary coverage.
2.
The first step in loading Primary coverage is to identify the subscriber.
Correct Answer
A. True
Explanation
The first step in loading Primary coverage is to identify the subscriber. This means that before any other actions can be taken, it is necessary to determine who the primary subscriber is. This could involve verifying their personal information, such as their name, date of birth, and insurance policy number. Once the subscriber has been identified, further steps can be taken to load their primary coverage into the system.
3.
The Subscriber section of the Coverage Summary window defaults to display:
Correct Answer
C. The guarantor
Explanation
The Subscriber section of the Coverage Summary window defaults to display the guarantor. The guarantor is the person responsible for the payment of the medical bills. It is important to have this information readily available for billing and insurance purposes.
4.
If the subscriber is not found in the system, users must register the subscriber.
Correct Answer
A. True
Explanation
If the subscriber is not found in the system, it is necessary for users to register the subscriber. This implies that if a subscriber's information is not present in the system, the user cannot proceed without registering them. Therefore, the statement is true.
5.
What button accesses the window to load a carrier number for a subscriber?
Correct Answer
A. [Add Subs Cov]
Explanation
The correct answer is [Add Subs Cov]. This button allows the user to access the window where they can load a carrier number for a subscriber. This suggests that the user wants to add coverage for a particular subscriber, and this button provides the necessary functionality to do so.
6.
Users should always enter an expiration date when loading Primary coverage.
Correct Answer
B. False
Explanation
Entering an expiration date is not necessary when loading Primary coverage. The expiration date is only required when loading Secondary coverage. Therefore, the statement is false.
7.
How should users complete the Type of Policy field when loading Medicare as the patient's Primary insurance?
Correct Answer
D. Medicare Primary
Explanation
When loading Medicare as the patient's Primary insurance, users should complete the Type of Policy field by selecting "Medicare Primary". This indicates that Medicare is the primary insurance for the patient, meaning it is the main insurance that will be billed for their healthcare services. This option distinguishes Medicare from other types of insurance policies, such as Medicare Part B or Group Policy, which may be secondary or supplemental to Medicare.
8.
Always load Primary insurance with a Filing Status of Automatic.
Correct Answer
A. True
Explanation
The statement suggests that it is always recommended to load Primary insurance with a Filing Status of Automatic. This means that when setting up primary insurance, it is advisable to select the option for automatic filing status. This indicates that the insurance company will automatically file claims on behalf of the insured individual, simplifying the process and ensuring timely reimbursement. By choosing this filing status, the insured person can avoid the hassle of manually submitting claims and potentially experiencing delays or errors in the process. Therefore, the given statement is true.
9.
If a patient has Medicare as a secondary payer, the Relationship to Medicare field does not need to be completed.
Correct Answer
B. False
Explanation
If a patient has Medicare as a secondary payer, the Relationship to Medicare field still needs to be completed. This field is used to indicate the type of relationship the patient has with Medicare, such as being a spouse or a dependent. Even though Medicare is not the primary payer in this case, it is still necessary to provide this information for proper billing and record-keeping purposes. Therefore, the correct answer is False.
10.
What information is appropriate to enter in the Comments field on the Insured Coverage Detail window?
Correct Answer(s)
A. Copay information
B. Customer Service numbers
C. Coverage updates
D. Coinsurance information
Explanation
The Comments field on the Insured Coverage Detail window is meant for entering any additional information related to the insured's coverage. This can include copay information, customer service numbers, coverage updates, and coinsurance information. These details can be useful for both the insured and the insurance company to have a comprehensive understanding of the coverage and any relevant information regarding it. Home phone numbers, on the other hand, are not appropriate to enter in the Comments field as they are not directly related to the insured's coverage.
11.
If at any time, there is a question regarding loading Primary insurance coverage, contact MedPro Knowledge Management.
Correct Answer
A. True
Explanation
This statement suggests that if there is any question or doubt about loading Primary insurance coverage, one should contact MedPro Knowledge Management. Therefore, the correct answer is "True" as it confirms the need to reach out to MedPro for assistance with loading Primary insurance coverage.