Struggling to find the right information for Facets interview questions? No worries, we are here to help you with that. There is not a lot of information that one can find on the internet. So we have grouped together 20 questions from our Facets experts.
Whether you are experienced or a fresher, it is important to get updated on what questions are being asked in the Facets interview. Go through the below 20 Frequently asked Facets interview questions and answers that help crack your interview.
Frequently Asked Facets Interview Questions:
- Explain about Facets.
- List the modules of Facets.
- What are the advantages of Facets?
- Where can we use Facets?
- How do Facets achieve real-time processing?
- Give the differences between medical claims and hospital claims?
- What are the fields in a claims screen?
- What is the difference between revenue code and procedure code?
- List the common errors faced while processing claims in Facets.
- How can you adjudicate a claim?
- How can you save a claim?
- Why do we need to pend a claim?
- How can you pend a claim?
- Name the important fields to process a claim.
- What do you know about Medicare and Medicaid programs?
- What are Facet optimization software products?
- Can facets integrate with other systems?
- By what technologies can customers benefit from the Facets solution?
- Facets tool is built upon what technologies?
- Explain about Facets insights?
- What is a containerized runtime in Facets?
- What are the container layers available in Facets?
- Explain about Closed-loop feedback.
- What is Facets CDH Suite?
- Explain about accumulator synchronization in Facets.
- What is Facets Assigned Risk Module?
- How does the Facets Workflow works?
- What does Facets Open Access Solution do?
- Explain about Blue Cross and Blue Shield plans.
- What is the Facets Dental module used for?
Explain about Facets.
Ans: The Facets tool is the core administrative processing system built by Cognizant in 1993. It is used to process medical and hospital transactions or facility claims. It helps in billing, claims processing, care management, and network management workflow. It is currently processing millions of transactions per week for more than 80 health plans. It integrates consumers, claims, care, and revenue management into a single platform.
2. List the modules of Facets.
Ans: The Facets tool offers a lot of modules. Some of them include subscribers/ members, providers, medical, billing, NetworX, etc.
3. What are the advantages of Facets?
Ans: Here are some of the advantages of the Facets tool.
- It provides increased stability.
- It has increased resilience to disturbances.
- The performance of the Facets tool is very reliable.
- It generates and consumes a huge amount of data.
- It offers real-time processing.
- It comes with security incorporated at each stage of the life cycle.
4. Where can we use Facets?
Ans: The Facets tool is widely used in the following places.
- Enrollment – When a new member has to be enrolled, ID card requests, update demographic details, etc.
- Customer Service – Manage customer service operations in real-time.
- Billing – It can perform comprehensive billing summary, billing requests, payments, etc.
- Interoperability – Provides an integrated view and access to consumer demands.
- Claim Processing – Helps with real-time claim submission and processing.
- Customer Transparency – It can be used where transparency is required for eligibility, benefits, and cost estimates.
5. How do Facets achieve real-time processing?
Ans: The architecture that leverages a data streaming platform is the event-driven ‘Facets Data Publishing’. The system can publish data generated by claims, providers, and subscribers in real-time. The clients can publish or consume data through batch or real-time processes.
6. Give the differences between medical claims and hospital claims?
Ans: Medical claims, also known as professional claims, are the claims that can be submitted by an individual provider or clinic. It is for the treatment received by an individual while in a hospital. Hospital claims, also known as facility claims, are the claims submitted by the hospitals.
7. What are the fields in a claims screen?
Ans: The claims screen contains the following fields.
- Provider id
- Subscriber id
- Date of service
- Diagnosis code
- Procedure code
- Revenue code
- Unit price
- Number of units
8. What is the difference between revenue code and procedure code?
Ans: Revenue code can only be used in hospital claims. The revenue codes are priced by the revenue codes.
Procedure code can only be used in medical claims. The medical claims are priced by the procedure codes.
9. List the common errors faced while processing claims in Facets.
Ans: Here are the common errors faced during claims processing in the Facets tool.
- Provider record not found
- Procedure code invalid
- Service definition error
10. How can you adjudicate a claim?
Ans: The F3 button is used in the Facets tool to adjudicate a claim.
11. How can you save a claim?
Ans: We can save a claim in the Facets tool using the F4 button.
12. Why do we need to pend a claim?
Ans: We can pend a claim when it is not paying as expected.
13. How can you pend a claim?
Ans: We can pend a claim in the Facets tool with the help of the F5 button.
14. Name the important fields to process a claim.
Ans: The important fields that are needed to process a claim are as follows.
- Date of submission
- Date of service
- Subscriber number
- Provider number
- Number of units
15. What do you know about Medicare and Medicaid programs?
Ans: Medicare is a federal insurance program for people over 65 years of age. Their medical bills are paid from trust funds. Medicaid is an assistance program run by state and local governments by following the federal guidelines. It servers poor or low-income people of any age.
16. What are Facet optimization software products?
Ans: To fine-tune the facets tool to an environment i.e., configure according to the customer needs, the following optimization solutions are offered to the IT teams.
- Claim test pro
- Configuration migration utility for Facets
- Facets enrollment toolkit
- Security management tool for Facets
- Supplemental mapping management tool for
- Test data generator
17. Can facets integrate with other systems?
Ans: The Facets tool can easily integrate with other systems by using REST-based APIs. The data and functionality are exposed with RESTful interfaces.
18. By what technologies can customers benefit from the Facets solution?
Ans: The Facets tool is available to clients with modern tools and capabilities.
Cloud – It is the native development environment of Facets. It can scale at the flexibility of the cloud.
Containers – Facets are made lightweight using container technologies. It speeds up development and optimizes cost.
Artificial intelligence and machine learning – To automatically deliver insights, AI and ML are incorporated into Facets solution.
19. Facets tool is built upon what technologies?
Ans: All the Facets modules are built on the following ‘ARCSS’ stack that results in high responsive single-page applications.
20. Explain about Facets insights?
Ans: The Facets insights feature is built upon machine learning models. It is used to predict the likelihood of a member leaving the plan. It can also recommend a remedy to the service representative who is interacting with that member.
- SQL-based RDBMS
21. What is a containerized runtime in Facets?
Ans: Facets provide containers for runtime services that improve performance and flexibility. We can also add auto-scaling and policy settings to the containers to manage resource utilization, which results in cost optimization. Containers make it easy to deploy different instances of Facets in multiple environments.
22. What are the container layers available in Facets?
Ans: The Facets is available in three container layers.
- Client layer – It is used for single-page applications that have a rich responsive user experience. We can include probabilistic logic into transaction processing for better results.
- Application layer – It provides light-weight, flexible, and scalable RESTful APIs. It incorporates runtime advances, orchestration, and containers.
- Data layer – It is the data streaming layer. It can hold data and publish it. It can also stream data from IoT devices.
23. Explain about Closed-loop feedback.
Ans: The closed-loop feedback system indicates that the system continuously learns, which results in the following.
- Increase in accuracy and stability
- Decrease in errors
- Calibrated sensitivity to events
- The performance will become reliable
- Increase in resilience to disturbances
24. What is Facets CDH Suite?
Ans: The Facets Consumer Directed Health (CDH) suite is used for the efficient administration of flexible health reimbursement arrangements, health savings accounts, and spending accounts. It helps with opportunities in care management, debit cards, benefits, funds, etc. It will provide a single source of data and information to improve HRA, HSA, and FSA benefit plans.
25. Explain about accumulator synchronization in Facets.
Ans: The Facets Accumulator Synchronization is used to synchronize accumulator data between Facets and third party ancillary benefit vendors. It ensures that benefit limits and deductibles are properly applied. It provides a real-time service interface for near real-time synchronization. It comes pre-mapped with the Facets core administration platform to enable rapid implementation.
26. What is Facets Assigned Risk Module?
Ans: The Facets Assigned Risk Module administers a variety of risk-sharing arrangements for Health Maintenance Organization (HMO) products like provider groups, IPAs, and facilities. It assumes the risk for claims that do not fall under defined services. We can configure business rules to structure provider reimbursements. It provides quality management for provider contracts.
27. How does the Facets Workflow works?
Ans: The Facets Workflow application is used to streamline the delivery of work to users. It enhances customer satisfaction and improves efficiency. It correlates repetitive errors to improve auto-adjudication rates. It routes information and reduces CSR response times. It helps in real-time work distribution that helps in eliminating duplication of work.
28. What does Facets Open Access Solution do?
Ans: The Facets Open Access Solution helps in data access for healthcare organizations to share, manage, and process Facets data. It integrates with external systems such that the data can be shared with third-party and custom developed applications. It offers a library of more than 300 web services that share data across the solution.
29. Explain about Blue Cross and Blue Shield plans.
Ans: Blue Cross and Blue Shield plans are effectively used for claims processing by communicating and sharing data with each other through the nationwide ITS network. It also supports member liability estimation and maintains accurate patient information. It allows users to send and receive any data related to providers, membership, billing, claims, etc.
30. What is the Facets Dental module used for?
Ans: The Facets Dental module helps in managing dental claims in an efficient way. It simplifies dental fee for service and managed care benefit plans. It is mainly used for dental claims processing, member administration, and customer service. It can process claims for both in-network and out-of-network providers.