What should you do if a claim is not on file while reviewing multiple claims?

Letters

Flashcard
•
English
•
12th Grade
•
Hard
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1.
FLASHCARD QUESTION
Front
Back
Open a second Manage claims task to document the claim not on file.
2.
FLASHCARD QUESTION
Front
Can you send letters from Create Correspondence during an active call?
Back
False
3.
FLASHCARD QUESTION
Front
What company code applies to the DMHC Process?
Back
200C
4.
FLASHCARD QUESTION
Front
What must you do if a member calls looking for a claim that is not on file?
Back
Send the required letter.
5.
FLASHCARD QUESTION
Front
What are the 4 ODG Letters?
Back
1. Contact CoveredCA 2. Missing claim or Need More Info 3. Prior Auth Missing information 4. Contact Employer Group
6.
FLASHCARD QUESTION
Front
What is the purpose of documenting claims not on file?
Back
To ensure accurate record-keeping and follow-up on unresolved claims.
7.
FLASHCARD QUESTION
Front
What is the significance of the company code in the DMHC Process?
Back
It identifies the specific procedures and regulations applicable to that company.
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