Billing & ClaimsQuestion 37 of 100
A remittance advice (RA) or explanation of benefits (EOB) is a document that:
a.Requests prior authorization for a service
b.Explains how a claim was adjudicated, including payments, adjustments, and denials
c.Lists the provider's entire fee schedule
d.Serves as the patient's insurance card
Explanation
A remittance advice (sent to the provider) or explanation of benefits (sent to the patient) details how each claim line was processed, showing amounts allowed, paid, adjusted, and any patient responsibility. Billers use the RA to post payments and identify denials for follow-up. Reason and remark codes on the RA explain adjustments.
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Related questions on this topic
- The UB-04 (CMS-1450) claim form is used to bill for:
- A 'clean claim' is best defined as a claim that:
- Claim 'scrubbing' refers to the process of:
- When a claim is denied, the first appropriate step for a billing specialist is usually to:
- The difference between a claim rejection and a claim denial is that a rejection:
- Medicare Part A primarily covers:
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