Certified Medical Administrative Assistants (CMAA) Practice Exam

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Question: 1 / 160

What happens to a claim that an insurance company discards due to technical errors?

It is permanently denied

It may be returned to the provider

When an insurance company discards a claim due to technical errors, it is typically returned to the provider for correction. This process allows the provider to identify and resolve the issues that led to the claim's rejection, whether they are related to incorrect coding, missing information, or other technical discrepancies. By returning the claim, the insurance company provides the opportunity for the provider to rectify the errors and resubmit the claim for consideration.

The incorrect options highlight different scenarios that do not accurately reflect the typical process for handling claims with technical errors. For instance, claims that are permanently denied would not provide an opportunity for correction, while automatically reprocessed claims do not typically exist for those with technical errors, as manual intervention is usually required. Claims kept in suspension may indicate ongoing processing issues rather than discarded claims needing correction. Hence, returning the claim to the provider for correction is the appropriate response in this context.

It is automatically reprocessed

It is kept in suspension

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