Certified Medical Administrative Assistants (CMAA) Practice Exam

Submitting a claim with inaccurate codes is likely to result in the claim being rejected or deemed invalid. When medical claims are processed, they must include specific codes that correspond to the diagnoses and procedures performed. These codes are essential for insurance companies to assess the validity of the charges and to ensure they align with the services rendered.

If the codes do not match correctly, insurers cannot finalize the claim, as they rely on this coding for accurate reimbursements. Consequently, a claim that is submitted with errors may be flagged for rejection, leading to delays in processing, additional work for the medical administrative staff to correct the inaccuracies, and ultimately, a longer wait time for payment. Being thorough in coding ensures that the claims align with the expectations of insurance providers and enhances the likelihood of receiving timely approval and payment.