Billing & ClaimsQuestion 61 of 100
A clearinghouse in the billing workflow functions to:
a.Receive claims from providers, check and format them, then route them to the appropriate payers
b.Set the patient's copayment amounts
c.Provide medical treatment
d.Assign diagnosis codes to encounters
Explanation
A clearinghouse is an intermediary that accepts electronic claims from providers, scrubs and standardizes them into the required format, and forwards them to the correct payers. It also returns rejection reports so errors can be fixed quickly. Using a clearinghouse streamlines electronic submission to many payers at once.
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Related questions on this topic
- 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:
- A superbill (encounter form) is used to:
- Which of the following would most likely cause a claim to be rejected at the clearinghouse before reaching the payer?
- On the CMS-1500 claim, diagnosis codes are linked to each service line by:
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