Which Involves Comparing the Claim to Payer Edits and the Patient's

question 35

Multiple Choice

Which involves comparing the claim to payer edits and the patient's health plan benefits to verify that the required information is available to process the claim, the claim is not a duplicate, payer rules and procedures have been followed, and procedures performed or services provided are covered benefits?

• A) claims adjudication
• B) claims payment
• C) claims processing
• D) claims submission

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Definitions:

Voltages

The difference in electric potential between two points, measured in volts, which drives an electric current between those points.

Currents

The flow of electric charge through a conductor, measured in amperes.

Data Manipulation

The process of changing or processing data to make it more organized, understandable, or suitable for a specific purpose.