Revenue Cycle Management (RCM) Practice Exam

The correct answer is that tertiary insurance is billed after all payments have been processed by primary and secondary insurers. Tertiary insurance comes into play when a patient has more than two insurance policies. In this situation, the primary insurer is billed first, followed by the secondary insurer, and only after those payments have been completed is the tertiary insurance billed.

This ordering is essential in the revenue cycle management process, as it ensures that all insurance liabilities are properly accounted for and that the maximum potential reimbursement is obtained for services provided. By adhering to this structured approach, healthcare providers can effectively navigate the complexities of multiple insurance policies and optimize their revenue.

Other types of insurance mentioned, like supplemental insurance, typically provide additional benefits but are not structured in the same way as tertiary insurance regarding the billing order. Nonparticipating insurance refers to plans that do not have agreements with specific healthcare providers, affecting the reimbursement process but not directly relating to billing sequences. Coordination of Benefits is an administrative process that helps determine which policy pays first, rather than indicating a specific type of insurance that is billed after payments from primary and secondary insurers.