Scenario library
Each scenario is a synthetic claim with a disposition to call, a veteran's teardown, and the systems-level fix that stops the miss upstream.
14 of 14 scenarios
The claim that sat in a drawer
What is the correct disposition for this claim?
Covered yesterday, not today
What is the correct disposition for this claim?
The claim that came back twice
What is the correct disposition for this claim?
The line that won't pass edits
One field on this claim makes it fail edits. Which one?
The diagnosis that won't stand
What is the correct disposition for this claim?
The copay that shouldn't be there
What is the correct disposition for this claim?
The E/M that came along for the ride
What is the correct disposition for this claim?
Two cards, one visit
What is the correct disposition for this claim?
The denial that wasn't
After reviewing the evidence, what is the correct disposition?
The bill that beat the contract
What is the correct disposition for this claim?
The units that don't add up
One field on this claim makes it fail edits. Which one?
The day with too many hours
What is the correct disposition for this claim?
The panel that got taken apart
What is the correct disposition for this claim?
The visit that came with a procedure
Work the modifier-25 decision step by step.