Claims Processing Involves the Verification of Medical Necessity for the Reported

question 62

Multiple Choice

Claims processing involves the verification of medical necessity for the reported procedures; this task is performed by:

• A) medical office specialists.
• B) medical directors.
• C) medical review examiners.
• D) automated claims processors.

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Definitions:

Skinner Box

An experimental apparatus developed by B.F. Skinner for studying behavioral conditioning in animals, typically through rewards and punishments.

Operant Conditioning

A method of learning that employs rewards and punishments for behavior, influencing the likelihood of that behavior being repeated.

Operant Conditioning

A training technique that adjusts the level of a behavior through positive reinforcement or negative punishment.

Behavior Consequences

Refers to the outcomes or results that follow an individual's behavior, which can influence future behaviors through reinforcement or punishment.