CMAA Practice Exam 2025 – Complete Guide for Exam Prep

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What is the outcome of a claim deemed invalid?

It is processed as usual

It is held for review

It is discarded without payment

When a claim is deemed invalid, it is typically discarded without payment. In the processing of medical claims, validity is crucial; claims that do not meet specific criteria, such as correct patient information, appropriate procedure codes, or necessary documentation, are rejected. This means they cannot be processed for payment by insurance companies.

Invalid claims are not held for review or processed further, as there is no basis for payment to be granted. While it may be possible for practitioners or administrative staff to address errors and resubmit a claim, the initial outcome of an invalid claim is that it is discarded, thus preventing unnecessary delays and facilitating the efficiency of the claims process.

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It can be revised and resubmitted

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