Match the following

-Code shown on an explanation of benefits (EOB) to explain the coverage determination or a denial
A) deductible
B) electronic remittance advice (ERA)
C) conversion factor
D) coinsurance
E) relative value unit
F) reason code
G) adjudication
H) copayment
I) withhold
J) allowed charge

Question

Match the following

-Code shown on an explanation of benefits (EOB) to explain the coverage determination or a denial
A) deductible
B) electronic remittance advice (ERA)
C) conversion factor
D) coinsurance
E) relative value unit
F) reason code
G) adjudication
H) copayment
I) withhold
J) allowed charge

Quizplus · Accepted Answer

Reason codes are used on EOBs to explain the coverage determination or denial.

Answer: A, D, H, J
 These terms are commonly used on EOBs to explain the patient's financial responsibility, such as deductible, coinsurance, copayment, and allowed charge.

Answer: B, E, I
 These terms are related to payment processing and may not always be included on an EOB. ERA refers to the electronic remittance advice, relative value unit is used to determine payment for certain services, and withhold may refer to a percentage of payment being held back by the insurer.

Match the Following -Code Shown on an Explanation of Benefits (EOB) to Explain