Last Year, a Practice's Returned Claims Were 8% of Total

question 20

Multiple Choice

Last year, a practice's returned claims were 8% of total submissions (600,000 claims) . The accuracy standards require 94.0% accuracy and you hope to see this standard applied enterprise wide for all coding. What does this standard allow for returned claims?

• A) 5.0% error rate
• B) 5.5% error rate
• C) 6.0% error rate
• D) 6.5% error rate

---

Definitions:

Proximate Cause

A legal concept that determines whether the harm or damage sustained by an individual is directly related to an event or action, playing a significant role in determining liability.

Legal Cause

A legally sufficient reason or justification for an action, event, or decision, especially in the context of litigation or legal obligations.

Punitive Damages

Monetary compensation awarded in a lawsuit that goes beyond what is necessary to compensate the plaintiff and is intended to punish the defendant for particularly egregious conduct.

Gross Negligence

An action committed with extreme reckless disregard for the property or life of another person.