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?

The RMC master file stores codes that explain why a payment was adjusted and any additional notes about the remittance. Reason codes provide the justification for an adjustment or denial, and remark codes supply extra information about the line item or reason for non-payment. Both types require fixed, standardized definitions in the master file so systems can consistently interpret remittance data and support reporting and analysis. Group codes, while used in remittance data to categorize or group claims, aren’t maintained as master records in the RMC file in the same way, so they aren’t the two that have records built for them.

The RMC master file stores codes that explain why a payment was adjusted and any additional notes about the remittance. Reason codes provide the justification for an adjustment or denial, and remark codes supply extra information about the line item or reason for non-payment. Both types require fixed, standardized definitions in the master file so systems can consistently interpret remittance data and support reporting and analysis. Group codes, while used in remittance data to categorize or group claims, aren’t maintained as master records in the RMC file in the same way, so they aren’t the two that have records built for them.

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