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They examine cost of claims to determine whether it is a reasonable or necessary, according to diagnosis.
Suggested Answer: C
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11 comments · newest first
PA
Paz
11 months ago
I thought it was all about the diagnosis, not just costs.
DO
Dottie
12 months ago
Wait, are billers really the ones doing this? Seems off.
SH
Shonda
12 months ago
Coders mainly focus on coding, not claims.
GL
Glynda
12 months ago
Totally agree, they know the ins and outs of claims.
HA
Haydee
1 year ago
Sounds like a job for health insurance specialists!
TA
Tanesha
1 year ago
I feel like I've seen similar questions, and it could go either way between coders and health insurance specialists, but I lean towards the latter.
LU
Lucina
1 year ago
This sounds like something a health insurance specialist would do, especially when determining if a claim is justified.
EL
Ellsworth
1 year ago
I remember a practice question about the role of billers in reviewing claims, but I can't recall if they specifically look at the cost versus diagnosis.
LI
Lisbeth
1 year ago
I think this might relate to how coders assess the appropriateness of claims based on the diagnosis codes, but I'm not entirely sure.
MA
Magda
1 year ago
Okay, I know RDDs can be generated from Hadoop file systems, but the partial update part is throwing me off. Let me re-read the question.
CA
Carma
1 year ago
No problem, I've got a good handle on this type of question. I'll methodically work through the details, identify the key information, and arrive at the correct true/false answer. Bring it on!