Which statement correctly describes the relationship between claim edit checks and claim edit rules?

• A. They are the same thing.
• B. Claim Edit Checks are Extensions (LPPs) and Claim Edit Rules are Rules (CERs).
• C. They are unrelated.
• D. Checks are CERs and Rules are LPPs.

Answer: (B)

The main idea is that the validation logic is split into rule definitions and the executable checks that enforce them. Claim edit rules (CERs) define the criteria that determine when a claim has an issue—the policy aspect of the edits. Claim edit checks, delivered as Extensions called LPPs, are the actual code pieces that run during claim processing to enforce those criteria in real time. They work together: CERs describe what constitutes an error, and LPPs provide the runnable checks that apply that rule set to claims. That’s why the correct statement is that claim edit checks are Extensions (LPPs) and claim edit rules are Rules (CERs). The other options would misstate the relationship by implying they’re the same, unrelated, or inverted in responsibility.