Billing & ClaimsQuestion 53 of 100
Verifying a patient's insurance eligibility before the visit helps to:
a.Confirm active coverage and benefits, reducing the risk of denials
b.Increase the provider's fee schedule
c.Change the patient's diagnosis
d.Eliminate the need for coding
Explanation
Eligibility verification confirms that the patient has active coverage, identifies the plan's benefits, and reveals copay, deductible, and authorization requirements before services are rendered. Doing this upfront prevents avoidable denials and helps collect patient responsibility. The HIPAA 270/271 transactions support electronic eligibility inquiries and responses.
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Related questions on this topic
- On the CMS-1500 form, the National Provider Identifier (NPI) is used to:
- The electronic equivalent of the paper CMS-1500 professional claim is the:
- Prior authorization (precertification) is:
- The 'place of service' code on a professional claim indicates:
- Which item is generally required for a clean professional claim?
- An appeal of a denied claim is:
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