When the clearinghouse says the claim is clean, it will be ________ when we load the reconciliation 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

When the clearinghouse says the claim is clean, it will be ________ when we load the reconciliation file.

A clean claim means it passes all automated edits and has the required data in the correct format, so there are no identifiable errors to prevent submission. When you load the reconciliation file, a clean claim will be Accepted, indicating it’s been received by the clearinghouse and is ready to move into the payer’s system for adjudication. It isn’t Pending (waiting for more info), not Rejected (errors exist), and not Yet Posted (payment posting occurs after adjudication).

A clean claim means it passes all automated edits and has the required data in the correct format, so there are no identifiable errors to prevent submission. When you load the reconciliation file, a clean claim will be Accepted, indicating it’s been received by the clearinghouse and is ready to move into the payer’s system for adjudication. It isn’t Pending (waiting for more info), not Rejected (errors exist), and not Yet Posted (payment posting occurs after adjudication).

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