Which of the following terms describes claims that need further attention due to lack of payment?

Which of the following terms describes claims that need further attention due to lack of payment?

• A. Outstanding claims
• B. Pending claims
• C. Processed claims
• D. Archived claims

Answer: (A)

The term that describes claims needing further attention due to a lack of payment is outstanding claims. Outstanding claims refer to those that have been submitted but not yet paid by the insurer or payer, often requiring follow-up or further investigation to understand the reasons for non-payment. Pending claims, while related, typically refer to claims that are awaiting processing or a decision by the payer rather than those that have been processed and are still outstanding due to lack of payment. Processed claims indicate that the claims have completed the review process and a determination has been made, whether payment is pending or not. Archived claims refer to those that have been stored away and are not actively being addressed, usually as a result of aging and being no longer relevant to immediate billing practices. Therefore, outstanding claims is the most accurate term for identifying claims that require further attention because of issues with payment.

The term that describes claims needing further attention due to a lack of payment is outstanding claims. Outstanding claims refer to those that have been submitted but not yet paid by the insurer or payer, often requiring follow-up or further investigation to understand the reasons for non-payment.

Pending claims, while related, typically refer to claims that are awaiting processing or a decision by the payer rather than those that have been processed and are still outstanding due to lack of payment. Processed claims indicate that the claims have completed the review process and a determination has been made, whether payment is pending or not. Archived claims refer to those that have been stored away and are not actively being addressed, usually as a result of aging and being no longer relevant to immediate billing practices. Therefore, outstanding claims is the most accurate term for identifying claims that require further attention because of issues with payment.