I am constantly getting emails from readers and new job aspirants in Facets tool which is used for healthcare insurance companies to process claims, that they want to crack the interview as a facets business analyst or Facets tester / Facets quality analyst. So here I am giving very very important Facets interview questions.
These questions are mainly for Facets Tester: (Facets Quality analyst)
Can you tell me about your experience as a Facets tester?
Ans: I have worked as a facets tester about 5 years and I worked on processing Medical claims and Hospital claims with in Facets tool. I also have good knowledge of providers, Members / Subscriber modules.
What is the difference between Medical claims and Hospital Claims?
Medical claims are also called professional claims and these are the claims submitted by individual providers or clinics. Hospital claims are also called as facility claims and these are submitted by hospitals.
What are the basic fields in a claims screen?
Basic fields in facets claims screen are Provider id, Subscriber id, date of service, diagnosis code, procedure code, revenue code, unit price, no of units.
Revenue code is used in which type of claims?
Revenue code is used in only hospital claims. Hospital claims are priced by revenue codes. Where as medical claims priced by procedure code.
What are the common errors while processing claims in facets?
Main errors in facets are ‘provider record not found’, ‘Procedure code invalid’, ‘Service definition error’ etc.
How to you adjudicate a claim?
Claim can be adjudicated by pressing F3 button.
How do you save a claim?
Claim is saved by pressing F4 button
How do you pend a claim?
Claim is pended by pressing F5 button.
Why do you need to pend a claim?
When the claim is not paying as expected we pend it for further review.
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