Office Administrative Assistant Practice Exam

The term that refers to claims containing errors that must be corrected and resubmitted for reimbursement is known as dirty claims. These are claims that have inaccuracies, missing information, or other issues that prevent them from being processed correctly by the insurance payer.

In contrast, a clean claim is one that is error-free and submitted with all required information, allowing for prompt payment. Pending claims may be in a state where they are being reviewed or awaiting approval but do not necessarily require correction. Fraudulent claims involve intentional deception or misrepresentation to receive an undeserved benefit and are treated very differently than claims needing correction. Understanding these distinctions is crucial for managing claims effectively in an administrative role within healthcare or insurance settings.