When the remittance advice is sent from the third-party payer to the provider, which action should the billing and coding specialist perform first?

When the remittance advice is sent from the third-party payer to the provider, which action should the billing and coding specialist perform first?

• A. Verify that the payment is posted to the patient account
• B. Ensure proper payment has been made
• C. Prepare an appeal for any denial
• D. Notify the patient of payment status

Answer: (B)

When remittance advice arrives, the immediate task is to verify the payment against the claim and the payer’s contract. This means checking that the amount paid, the patient responsibility, and any adjustments or denials align with what the claim should produce. Confirming proper payment at this stage ensures you’re not posting or taking further actions on an incorrect payment. Once you’ve verified the payment is correct, you can post it to the patient’s account and then handle subsequent steps—such as addressing discrepancies, initiating appeals for denials, or notifying the patient—based on what the RA shows. Therefore, the first action is to ensure proper payment has been made.

When remittance advice arrives, the immediate task is to verify the payment against the claim and the payer’s contract. This means checking that the amount paid, the patient responsibility, and any adjustments or denials align with what the claim should produce. Confirming proper payment at this stage ensures you’re not posting or taking further actions on an incorrect payment. Once you’ve verified the payment is correct, you can post it to the patient’s account and then handle subsequent steps—such as addressing discrepancies, initiating appeals for denials, or notifying the patient—based on what the RA shows. Therefore, the first action is to ensure proper payment has been made.