Question

What is the method employed by the payer when sending information to the medical practice regarding processed claims?

a. A separate ra for each processed claim
b. A separate ra and an individual eob for each claim processed
c. Only an ra upon request
d. An ra that covers a batch of processed claims

Answer 1

A payer typically sends an RA covering a batch of processed claims to a medical practice, which details payments and claim adjustments.

Step-by-step explanation:

When a payer sends information to a medical practice regarding processed claims, the method most commonly employed is d. An RA that covers a batch of processed claims. The Remittance Advice (RA) is a document provided to a healthcare provider that explains the payment of their claims, including any adjustments or denials. It usually comes as a comprehensive batch covering multiple patient claims communication rather than as separate documents for each individual claim. Likewise, the Explanation of Benefits (EOB) is typically sent to patients to explain which parts of the claim were covered by their insurance and what might be their responsibility, like co-pays or deductibles.