The Process Knowledge Test (PKT)

10 Questions | Total Attempts: 94

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Knowledge Quizzes & Trivia

Take this PKT test to improve your knowledge in the technical field, and if you pass this, that means you know it all about this process knowledge Test. Share the test with your colleagues and see who comes out as the most knowledgeable.


Questions and Answers
  • 1. 
    Based on below scenario – what will be your course of action:
    • A. 

      Send A letter - Ask for Confirmation of accident

    • B. 

      REJTD & PTI – there is enough information to reject this claim.

    • C. 

      FIPAY -there is enough information to pay this claim

    • D. 

      Pay with reservation, no same body parts historical claim. Xray correlates to fall description

    • E. 

      None

  • 2. 
    Based on below scenario – what will be your course of action:
    • A. 

      Send A letter - Ask for Confirmation of accident

    • B. 

      REJTD & PTI – there is enough information to reject this claim.

    • C. 

      FIPAY -there is enough information to pay this claim

    • D. 

      Pay with Reservation, no same body parts historical claim. Xray correlates to fall description

  • 3. 
    Patient has an IAC4000 policy and was  brought in via EMS. According to the mode of transportation, which 2 benefits would you immediately consider based on the benefit list provided.
    • A. 

      Acc Emergency Treatment and   Ambulance Ground/Water

    • B. 

       Ambulance Ground/Water and Transportation 2

    • C. 

      Ambulance Ground/Water  and Acc Injury/Auto Accident

    • D. 

      None

  • 4. 
    According to the med info, which benefits would you pay under Acc 1.0 assuming patient seek immediate medical attention?
    • A. 

      Emergency Treatment, Follow-up and Xray

    • B. 

      Emergency Treatment, Follow-up and Laceration

    • C. 

      Emergency Treatment and Follow-up

    • D. 

      Emergency Treatment and Concussion

  • 5. 
    According to the med info, which benefits would you pay?
    • A. 

      Emergency Treatment, Follow-up and Xray

    • B. 

      Emergency Treatment, Follow-up, Laceration No Suture, Xray and PT

    • C. 

      Emergency Treatment, Follow-up, Laceration, Xray and PT

    • D. 

      Emergency Treatment, Follow-up, Laceration, Xray, PT, Apliance and Surgery

  • 6. 
    Both claim seems to be altered, what  should be your course of action?
    • A. 

      Reject the claim

    • B. 

      Route as possible fraudulent  to Valarie Alston Nixon

    • C. 

      Call the Provider to verify accident – if altered route as possible fraud to Valarie

    • D. 

      Call the Provider to verify accident – if confirmed accident process as normal

    • E. 

      Both C& D

  • 7. 
    When services are provided by a Chiro, what insert should be included?
    • A. 

      U088

    • B. 

      U620

    • C. 

      U622

    • D. 

      U679

  • 8. 
    Provide the  Colonial diagnosis Code
    • A. 

      S5RLH

    • B. 

      O00XO

    • C. 

      O6LXH

    • D. 

      S6LSH

  • 9. 
    Provide the  Colonial diagnosis Code
    • A. 

      O20LO

    • B. 

      O9LSH

    • C. 

      O6RFH

    • D. 

      S70UH

  • 10. 
    Provide one latest  CLAIMSmart update applicable to Accident CLAIMSmart-Communications (sharepoint.com)
    • A. 

      Surgery Benefits - Accident Policies - CLA Outpatient Surgery Benefit - CLA

    • B. 

      Date of Loss/Claim Event Date - CLA

    • C. 

      Claims process was updated with information now reflects a priority 10 and below

    • D. 

      Claims more than priority 10 are to be reviewed as Managing Pending Claim.

    • E. 

      None of the above

    • F. 

      A&D

    • G. 

      B&C

    • H. 

      A, B, C, D

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