Certified Revenue Cycle Representative (CRCR) Practice Exam

What is the primary goal of using electronic and web portal verification in health plans?

1. To reduce paperwork.

2. To improve patient care quality.

3. To streamline claim processing.

4. To enhance patient engagement.

The correct answer is: To streamline claim processing.

The primary goal of using electronic and web portal verification in health plans centers around streamlining claim processing. This process involves the efficient gathering, verification, and submission of necessary patient information and insurance details. By utilizing electronic systems and web portals, healthcare organizations can reduce the time and resources required to handle claims manually, minimize errors, and enhance communication between different parties involved in the claim process. Streamlined claim processing leads to faster reimbursements and improved cash flow for healthcare providers. It also ensures that claims are submitted correctly the first time, which helps to reduce denials and delays that can occur with traditional paper-based methods. This efficiency ultimately benefits healthcare operations and supports overall revenue cycle management. While reducing paperwork, improving patient care quality, and enhancing patient engagement are indeed valuable outcomes of implementing technology in health plans, the core function of electronic and web portal verification specifically targets the efficiencies in the claims processing workflow. This is why streamlining claim processing is identified as the primary goal in this context.