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Week 1 Quiz STD Training

Get template

20 slides

Naomi Lund

This presentation covers initial interview steps, eligibility processes, disability benefits, resource tools for case managers, claim management, and definitions matching for insurance terms.

Slides (20)

1 - Freestyle
2 - Pick Answer SHI stands for?

1. Special Handling Instructions
2. Super Heavy Ideas
3. State History information
4. Senior Hierarchy Information
3 - Pick Answer Match the funding types!

1. Symetra calculates benefits only
2. Symetra assumes financial risk and responsibility
3. Symetra calculates benefit and taxes
4. Symetra medically manages the claim
4 - Pick Answer Where can you find job aid an articles regarding claims process and procedure?

1. GO
2. Swiftnet
3. Teams
4. KB
5. ClaimVantage
5 - Pick Answer Match the abbreviations with the term

1. Employer statement - ERS
2. employee - EE
3. Follow up - fu
4. DX - Diagnosis
6 - Pick Answer Match the details with the eligibility template field

1. Other income - salary continuation of $75/wk
2. PDE - $275.00/wk
3. Elimination Period - 7/7
4. Waiting Period - first of the month following 30 days
7 - Pick Answer We can gather details to use with the policy to determine eligibility from employer statements and eligibility feeds.

1. True
2. False
8 - Pick Answer What is the area can you find details regarding how to manage a claim based on the specific policyholder if applicable.

SHI
9 - Pick Answer Match the term with the definition

1. Light Jobs - Requires the ability to stand up to six hours in an eight-hour workday, lift up to 10 pounds frequently and up to 20 pounds occasionally.
2. Impairment - what we care about in STD claims—it tells us how the condition functionally limits the claimant.
3. Diagnosis - a label for a medical condition—it doesn’t tell us whether someone can work.
4. Job Classification - Refers to the categorization of a position based on its requirements and responsibilities
10 - Pick Answer If you are unsure of a diagnosis, you can use the ICD-10 code: R69-Illness Unspecified

1. False
2. True
11 - Pick Answer ____________ is a web-based reference tool containing evidence-based and physician-reviewed RTW duration guidelines.

1. Webmd
2. GO
3. KB
4. ClaimVantage
5. ODGuidelines
12 - Pick Answer Medical condition + Restrictions/Limitations=

Functional Impairment
13 - Pick Answer Categorize the following as Other Income or NOT Other Income.
14 - Pick Answer Where do we find "benefit amount" in a policy?

1. KB
2. You need to guess
3. The employee tells you
4. Section 1: Highlights of your plan
15 - Pick Answer In a 3/12 pre-existing condition clause, what does the “3” represent?

1. The lookback period checked for medical treatment
2. The maximum benefit duration
3. The insured period the employee must be covered
4. The waiting period before benefits begin
16 - Pick Answer Match the terms with their definitions

1. Insured Period - How long you must be insured following your initial effective date of coverage.
2. Treatment-free period - A set time period for which an employee did not treat even if treated during look back period
3. Pre-existing Condition - A provision that excludes the payments of benefits for a disability caused or contributed to by a Pre-Existing Condition.
4. Lookback period - A set time period for which an employee may have treated prior to becoming effective.
17 - Pick Answer Where can you find an EOI Report?

1. KB
2. content navigator
3. Claims system
4. GO
18 - Pick Answer An employee is hired on February 15, 2025. The plan has a waiting period of the first of the month following 90 days of employment. What is the Effective Date of Coverage for this employee?

1. June 1, 2025
2. May 15, 2025
3. May 1, 2025
4. August 1, 2025
19 - Pick Answer John Doe worked 3 hours on Tuesday, 11/25, then went home not feeling well. He was later admitted to the ER for a stroke and did not report to work on 11/26. What is the Date of Disability?

1. 11/26
2. 11/27
3. 11/28
4. 11/25
20 - Leaderboard

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Week 1 Quiz STD Training

Slides (20)

1 - Freestyle

2 - Pick Answer SHI stands for?

3 - Pick Answer Match the funding types!

4 - Pick Answer Where can you find job aid an articles regarding claims process and procedure?

5 - Pick Answer Match the abbreviations with the term

6 - Pick Answer Match the details with the eligibility template field

7 - Pick Answer We can gather details to use with the policy to determine eligibility from employer statements and eligibility feeds.

8 - Pick Answer What is the area can you find details regarding how to manage a claim based on the specific policyholder if applicable.

9 - Pick Answer Match the term with the definition

10 - Pick Answer If you are unsure of a diagnosis, you can use the ICD-10 code: R69-Illness Unspecified

11 - Pick Answer ____________ is a web-based reference tool containing evidence-based and physician-reviewed RTW duration guidelines.

12 - Pick Answer Medical condition + Restrictions/Limitations=

13 - Pick Answer Categorize the following as Other Income or NOT Other Income.

14 - Pick Answer Where do we find "benefit amount" in a policy?

15 - Pick Answer In a 3/12 pre-existing condition clause, what does the “3” represent?

16 - Pick Answer Match the terms with their definitions

17 - Pick Answer Where can you find an EOI Report?

18 - Pick Answer An employee is hired on February 15, 2025. The plan has a waiting period of the first of the month following 90 days of employment. What is the Effective Date of Coverage for this employee?

19 - Pick Answer John Doe worked 3 hours on Tuesday, 11/25, then went home not feeling well. He was later admitted to the ER for a stroke and did not report to work on 11/26. What is the Date of Disability?

20 - Leaderboard