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In Claims Administration Terminology, a Claims Investigation Is Correctly Defined

Question 197

Multiple Choice

In claims administration terminology, a claims investigation is correctly defined as the process of


A) reporting management information about services provided each time a patient visits a provider for purposes of analyzing utilization and provider practice patterns
B) obtaining all the information necessary to determine the appropriate amount to pay on a given claim
C) routinely reviewing and processing a claim for either payment or denial
D) assigning to each diagnosis or treatment reported on a claim special codes that briefly and specifically describe each diagnosis and treatment

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