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1. Please provider your full name and the name of the department in which you work.

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2. Where are all notes created by claims processors found?

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3. What kind of information do you find on the “UM” tab in Facets?

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4. Which application is primarily used in Facets when retrieving information about a claim?

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5. Beacon Mutual Insurance Company handles what kinds of claims?

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6. How do you know if an adjustment has been performed on a claim?

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7. When conducting a search in the Claims Inquiry + ITS application in Facets, which key combination do you use?

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8. To transfer to a member’s accumulator information, which of the following do you choose from the transfer menu?

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9. In which tab can you find a denial reason code in facets?

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10. What is “Networx” in relation to claims?

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11. In which tab do you find the check number in Facets?

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12. What is an “EXCD?”

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13. Under the Claims Section in blueLYNCS, where do you find check information?

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14. Using the WOW for Opening a call, which of the following is NOT required

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15. The Claim Check tab shows information about how a line has been processed if the charges have been rolled up or broken down into individual units for processing.

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16. Do all settlements appear in date order?

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17. Using the Call Center Information Matrix for Substance Abuse, Treamtment in the home is included as part of the basic benefit.

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18. CompAlliance is an insurance rider where the employer has purchased BCBSRI for their health insurance and Beacon Mutual for their workers compensation carrier. The coverage is usually indicated as a rider on the member’s BCBSRI ID number.

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19. Do all check numbers appear in Facets?

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20. When quoting accumulators in Facets, there are two places to check for accumulator information – The Family’s accumulators and the Member’s Accumulators.

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21. BP1 is a prefix assigned to a member id indicating that the member has coverage for a worker’s compensation case through Beacon Mutual Insurance AND has BCBSRI health insurance in their own name.

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22. Using the Substance Abuse Information Matrix, must services be considered medically necessary if they are rendered in an eligible inpatient partial hospital or intensive outpatient program setting?

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23. In Facets, accumulator information appears for both Facets and LRSP if the member’s coverage is for Rite Care or Direct Pay.

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24. Using the WOW for In or Out of Network verification, what three screens can be used to validate the provider’s network status? (Please select all three below)

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25. Using the Hospice Care Information Matrix, is respite care included as part of the standard benefit?

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26. According to the WOW for Policy Effective Dates, in blueLYNcS you never have to switch to the appropriate benefit type to quote correct information.

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27. When viewing accumulator information in blueLYNCS, which year(s) are referenced?

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