Billing & Claims第 60 / 100 题
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
解析
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.
免费刷完整 100 道题库 — 无需注册。
同考点相关题目
- 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:
- A clearinghouse in the billing workflow functions to:
- On the CMS-1500 claim, diagnosis codes are linked to each service line by: