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Unformatted text preview: that claim is put on hold and put off by payers because more information is needed for claim processing. The fourth step is the determination in which a decision is made on if they should pay the claim, deny the claim, or pay the claim at a reduced level. Lastly, the fifth step is payment in which if money is owed, the payer sends any necessary information to the provider along with a remittance advice (RA) or electronic remittance advice (ERA), a process that explains the payment decisions to the provider. Without the relationship between each step the process will become out of whack and medical providers may not get paid for their services and it will fall upon the patient. Medical billing is the core competency to and service provider that way they can efficiently manage all your billing needs....
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This note was uploaded on 12/14/2011 for the course AXIA OF UO AAAA0GOT71 taught by Professor Gaylordvanalstine during the Spring '09 term at University of Phoenix.
- Spring '09