Billing & Claims第 39 / 100 题
The difference between a claim rejection and a claim denial is that a rejection:
a.Occurs before adjudication due to errors and can be corrected and resubmitted, while a denial occurs after the payer processes the claim
b.Always results in full payment
c.Can never be corrected
d.Only happens with paper claims
解析
A rejected claim never entered the payer's adjudication system, typically because of missing or invalid data, and can be fixed and resubmitted as a new claim. A denied claim was processed but payment was refused, and it generally must be appealed or corrected through the payer's formal process. Distinguishing the two guides the correct follow-up path.
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