Billing & ClaimsQuestion 60 of 100
Which of the following would most likely cause a claim to be rejected at the clearinghouse before reaching the payer?
a.A correctly matched diagnosis and procedure
b.A valid, active NPI
c.Accurate patient demographics
d.An invalid or missing subscriber identification number
Explanation
Clearinghouses perform front-end edits and will reject claims with missing or invalid data such as an incorrect subscriber ID, invalid NPI, or format errors before the claim reaches the payer. These rejections can be corrected and resubmitted quickly. Catching errors at this stage is faster than resolving a payer denial.
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