Facets Testing Interview Questions & Answers

  1. Question 1. What Is The Difference Between Medical Claims And Hospital Claims?

    Answer :

    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.

  2. Question 2. What Are The Basic Fields In A Claims Screen?

    Answer :

    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.

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  4. Question 3. Revenue Code Is Used In Which Type Of Claims?

    Answer :

    Revenue code is used in only hospital claims. Hospital claims are priced by revenue codes. Where as medical claims priced by procedure code.

  5. Question 4. What Are The Common Errors While Processing Claims In Facets?

    Answer :

    Main errors in facets are ‘provider record not found’, ‘Procedure code invalid’, ‘Service definition error’ etc.

  6. Question 5. How To You Adjudicate A Claim?

    Answer :

    Claim can be adjudicated by pressing F3 button.

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  8. Question 6. How Do You Save A Claim?

    Answer :

    Claim is saved by pressing F4 button.

  9. Question 7. How Do You Pend A Claim?

    Answer :

    Claim is pended by pressing F5 button.

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  11. Question 8. Why Do You Need To Pend A Claim?

    Answer :

    When the claim is not paying as expected we pend it for further review.

  12. Question 9. What Is Facets?

    Answer :

    Facets is a healthcare tool which is used to process medical and hospital or facility claims. This is owned by cognizant and Indian based company which is listed in NASDAQ. 80% of its employees are Indians.

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  14. Question 10. How Many Modules Will Be There In Facets?

    Answer :

    Facets has many modules such as Providers, subscribers/members, Medical, Billing, NetworX etc

  15. Question 11. What Are The Important Fields To Process A Claim?

    Answer :

    Date of submission., date of service, subscriber number, provider number, amount, units.

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  17. Question 12. What Is The Difference Between Medicare And Medicaid Programs?

    Answer :

    Medicare is a is a federal program to help people who are above 65 years of age.

    Medicaid is a state government program to help people who are poor.

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