Of the three kinds of codes a payer might send (Group, Reason, and Remark), which two have records built for them in the RMC master file?

Study for the RHB330 Resolute Hospital Billing Claim and Remittance Test with questions, hints, and explanations. Enhance your billing skills and excel in your exam!

Multiple Choice

Of the three kinds of codes a payer might send (Group, Reason, and Remark), which two have records built for them in the RMC master file?

Reason codes and remark codes are the ones that have records built in the RMC master file. The RMC master file is used to map the codes that explain why a claim was adjusted or denied (reason codes, often CARCs) and the additional notes that accompany those adjustments (remark codes, or RARCs). Group codes, while used in remittance advice to indicate payer grouping or the payer’s handling category, are not stored in this master file. So the two types with defined records in the RMC master file are the reason codes and the remark codes.

Reason codes and remark codes are the ones that have records built in the RMC master file. The RMC master file is used to map the codes that explain why a claim was adjusted or denied (reason codes, often CARCs) and the additional notes that accompany those adjustments (remark codes, or RARCs). Group codes, while used in remittance advice to indicate payer grouping or the payer’s handling category, are not stored in this master file. So the two types with defined records in the RMC master file are the reason codes and the remark codes.

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