When transmitting claims, which practice ensures successful reimbursement?

• A. Submitting only after payer approval.
• B. Posting payments without coding.
• C. Accurate coding and timely submission.
• D. Filing claims to multiple payers randomly.

Answer: (C)

Accurate coding and timely submission are essential because they ensure the claim clearly represents the exact services provided and reaches the payer within the window for processing. Using correct CPT/HCPCS codes and ICD-10-CM diagnoses (plus any required modifiers) aligns the bill with payer guidelines, coverage rules, and appropriate reimbursement, reducing the chance of denials or underpayment.

When these practices are followed, claims are more likely to be processed smoothly and paid correctly. Accurate coding prevents mismatches between what was done and what’s billed, while timely submission avoids denials that occur when claims miss filing deadlines.

Submitting only after payer approval isn’t how standard billing works, since approval isn’t typically obtained before submission. Posting payments without coding disconnects the payment from the specific services rendered, creating confusion and audit risk. Filing claims to multiple payers randomly can lead to duplicates and compliance issues.