A rule is made up of one or more criteria. Each criterion is composed of three parts. Which three parts make up a criterion?

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Multiple Choice

A rule is made up of one or more criteria. Each criterion is composed of three parts. Which three parts make up a criterion?

In a rule, each criterion tests a single attribute against a value using a comparison. The first piece identifies the attribute to check—the property representing the data field on the claim or remittance, such as service date, procedure code, or charge amount. The second piece is the operator, the way you compare—equals, not equals, greater than, less than, in, etc. The third piece is the value, the specific data you compare to, such as a CPT/HCPCS code like 99213, a date like 2024-01-01, or a dollar amount like 100.00. Put together, property operator value forms a single logical condition. A rule can include multiple criteria connected by AND/OR to determine whether the rule fires. The other options describe structures that don’t match how a criterion is typically built in these rules.

In a rule, each criterion tests a single attribute against a value using a comparison. The first piece identifies the attribute to check—the property representing the data field on the claim or remittance, such as service date, procedure code, or charge amount. The second piece is the operator, the way you compare—equals, not equals, greater than, less than, in, etc. The third piece is the value, the specific data you compare to, such as a CPT/HCPCS code like 99213, a date like 2024-01-01, or a dollar amount like 100.00. Put together, property operator value forms a single logical condition. A rule can include multiple criteria connected by AND/OR to determine whether the rule fires. The other options describe structures that don’t match how a criterion is typically built in these rules.

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