An insurance claims department compares the fee the doctor charges with the benefits provided by the patient's health plan. This is called the ____.
A. payment of benefits
B. review of medical necessity
C. explanation of benefits
D. review for allowable benefits
E. payment and remittance advice
D. review for allowable benefits
In the review for allowable benefits, the claims department compares the fees the physician has charged with the benefits provided by the patient's health insurance policy to determine the amount of deductible or coinsurance the patient owes.
Health Professions
You might also like to view...
Florida allows reciprocity only if an individual took the NAPLEX exam within the prior:
a. 5 years b. 8 years c. 12 years d. 15 years
Health Professions
The physical location where a healthcare professional delivers services to a patient is known as the:
A. place of care. B. care location. C. point of care. D. location of care.
Health Professions