Claims may be downcoded because_____.
A) the patient has not paid the copayment
B) service was performed out of state
C) the documentation fails to support the level of service claimed
D) insurance company has refused to pay the higher code
Correct Answer:
Verified
Q1: Health plan process of examining claims and
Q2: Adjudication is made up of five steps
Q3: The process of gathering information to begin
Q4: The term used by payers to indicate
Q5: Payer's decision about the benefits due for
Q7: _ is the use of a procedure
Q8: What is the name of a transaction
Q9: ERA is the abbreviation for _.
A) electronic
Q10: Monitoring claims during adjudication requires two types
Q11: Classification of accounts receivable by length of
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