What is the process of sorting claims upon submission to verify information about the patient and provider?

Prepare for the Revenue Cycle Management Exam with our comprehensive quiz. Enhance your knowledge with interactive questions and detailed explanations. Boost your confidence and get ready to excel!

Claims processing is the correct answer because it encompasses the systematic approach to handling insurance claims once they are submitted. This phase is crucial as it involves verifying the accuracy of the information provided about both the patient and the provider to ensure that claims are legitimate and eligible for reimbursement. During claims processing, the claims are evaluated for completeness and correctness, which includes checking for necessary documentation and determining whether the services claimed align with the patient's insurance coverage.

In contrast, underwriting generally pertains to assessing risks before accepting insurance applications and is not directly involved in the claims verification process. Claims submission is simply the act of submitting the claims for reimbursement and does not involve any evaluation or verification. Claim adjustment refers to the act of revising claims that have already been processed due to errors or changes in circumstances, which is a different stage in the revenue cycle. Therefore, claims processing plays a pivotal role in ensuring that claims are accurately sorted and validated right after submission.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy