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Insurance Handbook, Chapter 9-Problem Solving

AB
EOBdocument detailing services billed, and payments received
Remittance advicepayment voucher
suspended claimpending claim
tickler filesuspense file
inquirytracer
delinquent claimoverdue
suspensepending indeterminate state of an insurance claim
denied claimclaim submitted but which has been rejected by the insurance carrier
overpaymentmoney paid over and above the amount due
appealwritten request for redetermination
reviewto look over a claim to determine how much payment should be made
rejected claimclaim that has been discarded due to a technical problem
rebillsecond request for payment
peer reviewreview by one or more physicians
lost claiminsurance claim that cannot be located after sending it to an insurer


Medical Insurance Billing & Coding Instructor
Everest College
Ontario, CA

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