Introduction To Benefit Coding Process

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| By Balaji_87
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Balaji_87
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Quizzes Created: 1 | Total Attempts: 191
| Attempts: 191
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  • 1/14 Questions

    Once the Claim is entered into the claim processing system, the system checks the validity of that claim. (1 Mark)

    • True
    • False
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About This Quiz

This quiz on 'Introduction to Benefit Coding Process' assesses understanding of the roles, systems, and advantages involved in coding benefits for insurance claims. It evaluates knowledge on NASCO and the validity checks performed by claim processing systems, providing learners with insights into efficient insurance operations.

Claims Processing Quizzes & Trivia

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  • 2. 

    Who is responsible for translating the requested benefits into codes understandable to the system? (1 Mark)

    • Code Tester

    • Benefit Coder

    • NASCO

    • NPS

    Correct Answer
    A. Benefit Coder
    Explanation
    The Benefit Coder is responsible for translating the requested benefits into codes that the system can understand. This role involves converting the information about the benefits into a standardized format that can be processed by the system. The Benefit Coder ensures that the codes accurately represent the requested benefits and are compatible with the system's coding structure.

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  • 3. 

    NASCO proviodes the single system solution to the insurance plans for processing of claims. (1 Mark)

    • True

    • False

    Correct Answer
    A. True
    Explanation
    NASCO provides a single system solution for processing insurance claims, indicating that they offer a comprehensive and integrated solution for managing the claims process. This suggests that NASCO's system can handle all aspects of processing claims, including data entry, verification, adjudication, and payment. By offering a single system solution, NASCO aims to streamline and simplify the claims process for insurance plans, potentially improving efficiency and reducing errors.

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  • 4. 

    NASCO stands for _________________________________________________ (1 Mark)

    Correct Answer
    National Account Service COmpany
    Explanation
    NASCO stands for National Account Service Company. This is a company that provides services related to national account management. They assist in managing and coordinating various aspects of national accounts, such as billing, customer service, and contract negotiations. The acronym NASCO represents the company's focus on providing services for national accounts.

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  • 5. 

    When Benefit Coding is implemented, Manual Intervention is increased. (1 Mark)

    • True

    • False

    Correct Answer
    A. False
    Explanation
    When Benefit Coding is implemented, Manual Intervention is not increased. This means that the process of Benefit Coding does not require more manual intervention or human involvement. The implementation of Benefit Coding is designed to automate and streamline the process, reducing the need for manual intervention and increasing efficiency. Therefore, the correct answer is False.

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  • 6. 

    NASCO, LLC., was found in ____________ (1 Mark)

    • 1897

    • 1987

    • 1978

    • 1879

    Correct Answer
    A. 1987
    Explanation
    NASCO, LLC., was founded in 1987.

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  • 7. 

    ________________________________ Phrase refers to the layers of a benefit package that have a three dimensional quality. (1 Mark)

    • Benefit File

    • Benefit Structure

    • Benefit String

    • Benefit Database

    Correct Answer
    A. Benefit Structure
    Explanation
    The phrase "layers of a benefit package that have a three dimensional quality" suggests that the benefit package has multiple levels or components that interact with each other in a complex way. This implies that the benefits are structured in a specific manner to provide a comprehensive and integrated package. Therefore, the correct answer is "Benefit Structure".

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  • 8. 

    NASCO’s System Infrastructure is supported by ___________________________ (1 Mark)

    • NPS

    • Secret Agent

    • IBM

    • Service Provider

    Correct Answer
    A. IBM
    Explanation
    NASCO's System Infrastructure is supported by IBM. IBM is a well-known technology company that provides various services and solutions for businesses, including system infrastructure support. Therefore, it is reasonable to assume that IBM is the correct answer for this question.

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  • 9. 

    What is the single system solution helps the process of benefit coding? (1 Mark)

    • NASCO

    • NPS

    • IBM

    • Benefit Coder

    Correct Answer
    A. NPS
    Explanation
    NPS (National Pension System) is the single system solution that helps the process of benefit coding. It is a government-sponsored pension scheme in India that allows individuals to contribute towards their retirement savings. NPS provides a unique Permanent Retirement Account Number (PRAN) to each subscriber, which is used for coding and managing their benefits. This system simplifies the process of benefit coding by centralizing all the information and ensuring efficient management of retirement savings.

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  • 10. 

    Usage of NASCO by the insurance companies results in __________________, __________________ & ____________________ (3 Marks)

    • Reduced Costs

    • Easy access

    • Reduced maintenance

    • Increasing quality

    • Increasing Manpower

    • Increasing performance

    Correct Answer(s)
    A. Reduced Costs
    A. Increasing quality
    A. Increasing performance
    Explanation
    The usage of NASCO by insurance companies leads to reduced costs because it streamlines processes and reduces the need for manual intervention. It also results in increasing quality as NASCO provides accurate and efficient data management, ensuring fewer errors and improved customer service. Additionally, NASCO enhances performance by automating tasks and improving overall operational efficiency.

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  • 11. 

    What language is a benefit coder reading when they read the Benefit File? (2 Marks) Choose the Correct two values from the given options.

    • Basic Values

    • NASCO

    • Benefit Plan

    • Mnemonics

    Correct Answer(s)
    A. Basic Values
    A. Mnemonics
    Explanation
    The Benefit File is a file that contains information about benefits. When a coder reads the Benefit File, they need to understand the language in which the file is written. The two values that are mentioned as correct answers, Basic Values and Mnemonics, are likely the languages in which the Benefit File is written. By reading these languages, the coder can interpret and understand the information in the file.

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  • 12. 

    What is the term refer the description of benefits required by the contractual agreement between the plan and the customer? (1 Mark)

    • Benefit form

    • Business Requirement

    • Contracted Benefits

    • None of the above

    Correct Answer
    A. Business Requirement
    Explanation
    The term that refers to the description of benefits required by the contractual agreement between the plan and the customer is "Business Requirement". This term implies that the benefits outlined in the agreement are necessary for the successful operation and fulfillment of the business. It suggests that the benefits are not just optional or discretionary, but rather essential components of the contractual agreement.

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  • 13. 

    What are the advantages of coding the benefits? (5 Marks)  Choose the correct five values from the given options.

    • Less Memory Space

    • Easy Understanding

    • Security

    • Enhancement of Auto-Adjudication

    • Quick Claim Processing

    • Reduced Time

    • Easy to Code

    • Less Paperwork

    Correct Answer(s)
    A. Less Memory Space
    A. Security
    A. Enhancement of Auto-Adjudication
    A. Reduced Time
    A. Less Paperwork
    Explanation
    The coding of benefits has several advantages. Firstly, it helps in saving memory space as coding allows for more efficient storage of data. Secondly, it enhances security by protecting sensitive information through encryption and access control. Thirdly, coding enables the automation of adjudication processes, leading to faster and more accurate claim processing. Additionally, it reduces time by streamlining workflows and eliminating manual tasks. Lastly, coding benefits also result in less paperwork as digital records can replace physical documents.

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  • 14. 

    What are the analytical skills a benefit coder must possess? (5 Marks)

Quiz Review Timeline (Updated): Mar 21, 2023 +

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Mar 08, 2011
    Quiz Created by
    Balaji_87
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