AAMA CMA Practice Question

Before submitting an insurance claim, it is crucial to verify patient insurance eligibility and benefits. This directly affects claim approval because if a patient is not eligible for the services billed, the claim will be denied. Verifying insurance includes confirming the patient’s coverage on the date of service, deductible amounts, co-insurance, and copay responsibilities, as well as any exclusions or limitations in their policy. This step reduces the risk of denials for issues such as non-covered services or inactive insurance and contributes to a smoother revenue cycle process.