Billing & ClaimsQuestion 38 of 100
When a claim is denied, the first appropriate step for a billing specialist is usually to:
a.Immediately write off the balance
b.Bill the entire amount to the patient
c.Review the denial reason on the remittance advice to determine the cause
d.Resubmit the identical claim without changes
Explanation
Understanding why a claim was denied is essential before taking corrective action; the remittance advice provides reason and remark codes that explain the denial. Some denials require correcting and resubmitting the claim, while others require a formal appeal. Blindly resubmitting an unchanged claim usually results in another denial.
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Related questions on this topic
- A 'clean claim' is best defined as a claim that:
- Claim 'scrubbing' refers to the process of:
- A remittance advice (RA) or explanation of benefits (EOB) is a document that:
- The difference between a claim rejection and a claim denial is that a rejection:
- Medicare Part A primarily covers:
- Medicare Part B primarily covers:
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