Certified Revenue Cycle Representative (CRCR) Practice Exam

What advantage does electronic claims processing provide?

1. Higher rates of insurance fraud

2. Providers can electronically view patient's eligibility

3. Reduced paperwork for patients

4. Increased processing times for claims

The correct answer is: Providers can electronically view patient's eligibility

Electronic claims processing offers numerous advantages that significantly enhance the efficiency and effectiveness of healthcare operations. One of the key benefits is that providers can electronically view a patient's eligibility. This real-time access to eligibility information allows providers to confirm insurance coverage and benefits before services are rendered. By having immediate visibility into patient eligibility, healthcare providers can streamline the registration process, reduce denied claims due to eligibility issues, and improve overall patient communication. This capability also aids in reducing delays in care, as providers can better manage treatment plans based on the patient's coverage availability. Furthermore, online access to this information minimizes the chances of administrative errors that can occur with manual data entry and increases the likelihood of claim acceptance upon submission. Overall, the ability to electronically check patient eligibility is a crucial aspect of electronic claims processing that enhances revenue cycle management by promoting timely and accurate billing practices.