Billing & Claims第 37 / 100 题

A remittance advice (RA) or explanation of benefits (EOB) is a document that:

a.Requests prior authorization for a service
b.Explains how a claim was adjudicated, including payments, adjustments, and denials
c.Lists the provider's entire fee schedule
d.Serves as the patient's insurance card

解析

A remittance advice (sent to the provider) or explanation of benefits (sent to the patient) details how each claim line was processed, showing amounts allowed, paid, adjusted, and any patient responsibility. Billers use the RA to post payments and identify denials for follow-up. Reason and remark codes on the RA explain adjustments.

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