Question

What does the provider receive from the insurance company that summarizes the amounts paid for services rendered to covered patients?

A. Premium notice.
B. Remittance advice.
C. Coordination of benefits.
D. Fee schedule.

Answer 1

The provider typically receives a remittance advice from the insurance company that summarizes the amounts paid for services rendered to covered patients. Hence, the correct answer is option (B).

Step-by-step explanation:

The document that a provider receives from the insurance company summarizing the amounts paid for services rendered to covered patients is known as the remittance advice. This statement details the services billed, the amounts approved by the insurance, adjustments, the amounts paid, and any denials or rejections of claims.

Health care providers use remittance advice to reconcile their accounts and ensure that they have been properly compensated according to their service contract with the insurance company or health maintenance organization (HMO).