Billing & ClaimsQuestion 55 of 100
Which item is generally required for a clean professional claim?
a.The provider's personal bank account number
b.The patient's employer performance review
c.Valid diagnosis and procedure codes with supporting patient and insurance information
d.A photograph of the patient
Explanation
A clean claim requires accurate patient demographics, insurance information, provider identifiers, and valid diagnosis and procedure codes that support medical necessity. Missing or mismatched data is a leading cause of rejections. Verifying these elements before submission maximizes first-pass acceptance.
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Related questions on this topic
- Prior authorization (precertification) is:
- Verifying a patient's insurance eligibility before the visit helps to:
- The 'place of service' code on a professional claim indicates:
- An appeal of a denied claim is:
- The term 'assignment of benefits' means that the patient:
- When Medicare is the secondary payer (MSP), it means that:
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