A Claim That Is Removed from a Payer's Automated Processing

question 67

Multiple Choice

A claim that is removed from a payer's automated processing system for additional review is subject to:

• A) preauthorization.
• B) manual review.
• C) medical-necessity examination.
• D) claims edit.

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Definitions:

Female Managers

Women who hold management positions within organizations, overseeing operations and making strategic decisions.

Senior Citizens

Individuals of an older age, usually defined as people of retirement age, typically 65 years or older, who may qualify for certain benefits and considerations.

Structural Integration

The alignment and coordination of an organization's systems, processes, and structures to improve efficiency, communication, and performance.

Intergroup Conflict

Disputes or disagreements between different groups or teams, often caused by competing objectives, resources, or ideologies.