Claims Flashcards
1
Q
What is a Claim?
A
It is a request for reimbursement of the medical services which were provided.
2
Q
What is a Clean Claim?
A
This Claim includes all required information/documentation and will successfully be adjudicated.
3
Q
What is a Pending Claim?
A
This claim is in process and has not yet been adjudicated.
4
Q
What is a Delinquent Claim?
A
This is a claim that has not been adjudicated/paid. This claim will show up in your Aging Report(AR).
5
Q
What is an Open Claim?
A
This claim has been sent to the third-party payer for adjudication.
6
Q
What is a Dirty Claim?
A
This is a claim that includes errors and will be rejected by the Clearinghouse or denied by the Payer.
