Which term best describes claims that have been submitted to a payer but are not yet processed?

The term that best describes claims submitted to a payer but not yet processed is "Open Claims." Open claims refer to the status of claims where the healthcare provider has submitted the necessary documentation for reimbursement, but the payer has not yet taken action to resolve or process the claim.

This status indicates that these claims are in a waiting period, where the payer is expected to review the information submitted and either approve or deny the claim. Understanding the open claims status is essential for healthcare providers as it directly impacts cash flow and accounts receivable management.

The other terms listed do not describe this status. For example, Electronic Funds Transfer refers to the electronic movement of money and is not related to the status of claims. Coinsurance is a cost-sharing arrangement between the insurer and the insured, pertaining to the percentage of costs each party pays after the deductible has been met, and thus does not relate to the processing status of claims. Electronic Remittance Advice is a document sent by payers to inform providers about the payment decisions made regarding the claims submitted, which occurs after claims have been processed rather than during their open status.