Insurance Eligibility and Shield Errors

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Quiz: Insurance Eligibility

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Joelis Maria Fermin

United States

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Insurance Eligibility and Shield Errors


Froggy Jumps Insurance Eligibility and Shield ErrorsOnline version Quiz: Insurance Eligibility by Joelis Maria Fermin 1 What does it mean when an Insurance Eligibility and Shield alert shows a positive return? a The patient has no insurance b The patient is eligible according to the plan entered c The system could not verify the information 2 Does the green Shield mean everything is correct? a Yes, green always means go b Not necessarily — green does NOT mean go c Only if a check mark appears 3 What must always be verified before scheduling the patient, even if the Shield shows green? a That the Medical Group entered is correct b That the patient has a copay c That the ID is typed in capital letters 4 Why might a Shield Error appear? a Because the system identified an error in the plan entered b Because the patient did not show up c Because the copay was entered incorrectly 5 Which of the following can trigger a Shield Error? a Entering an HMO correctly b Adding an additional phone number c Entering Straight Medicare or Medi-Cal when the patient actually has a replacement or advantage plan 6 What happens when plans are entered in the wrong order (for example, secondary listed as primary)? a The system ignores the error b A Shield Error is generated c Eligibility is automatically approved 7 If an incorrect plan type is selected (for example, PPO instead of HMO), what will happen? a A Shield Error will be generated b Only the admin will be notified c Nothing, the system will fix it automatically 8 What can cause a Yellow Question Mark Error? a Connection issues or minor system errors b Scheduling conflict c Missing copay information 9 What is a common cause of an error related to patient information? a Missing gender information b Transposed or missing numbers in the ID, or an incorrect name spelling c Wrong work phone number 10 What should you do if the name on the insurance card does not match the name in the system? a Run eligibility manually during pre-processing b Cancel the appointment c Ignore the mismatch 11 What does it mean when eRAD RIS is not configured to run against the insurance company’s system? a Eligibility must be verified manually b The patient must pay a deductible c The patient is not eligible 12 What happens to the amount to collect when an error occurs or the system cannot run eligibility? a It is calculated automatically b No amount to collect can be given to the patient c The default copay is charged 13 What does a terminated coverage error indicate during scheduling? a Coverage is inactive, and the patient must contact their insurance b The patient’s plan is active c The patient has multiple plans 14 What should you do if the coverage appears terminated? a Schedule the appointment, note that the patient was informed, and mark additional pre-pro b Do not schedule the patient c Delete the patient from the system 15 What does it mean if the patient is outside their eligible dates? a The system is outdated b The patient’s coverage will start later; no need to discuss with the patient c The insurance is canceled 16 When any eligibility or shield error appears, what should NOT be done? a Give an amount to collect to the patient b Review the entered plan c Confirm data with the patient 17 Even if the Shield shows green, what must be confirmed with the patient? a The appointment time b The Policy Number or Member ID c Their date of birth

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Insurance Eligibility and Shield Errors

Froggy Jumps

About this activity

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Insurance Eligibility and Shield ErrorsOnline version

by Joelis Maria Fermin

What does it mean when an Insurance Eligibility and Shield alert shows a positive return?

Does the green Shield mean everything is correct?

What must always be verified before scheduling the patient, even if the Shield shows green?

Why might a Shield Error appear?

Which of the following can trigger a Shield Error?

What happens when plans are entered in the wrong order (for example, secondary listed as primary)?

If an incorrect plan type is selected (for example, PPO instead of HMO), what will happen?

What can cause a Yellow Question Mark Error?

What is a common cause of an error related to patient information?

What should you do if the name on the insurance card does not match the name in the system?

What does it mean when eRAD RIS is not configured to run against the insurance company’s system?

What happens to the amount to collect when an error occurs or the system cannot run eligibility?

What does a terminated coverage error indicate during scheduling?

What should you do if the coverage appears terminated?

What does it mean if the patient is outside their eligible dates?

When any eligibility or shield error appears, what should NOT be done?

Even if the Shield shows green, what must be confirmed with the patient?