Pacific BPO Accounts Receivable Analyst Interview Questions and Answers

Q1. What is the concept of denial in Revenue Cycle Management (RCM)?
Ans. 
Denial in Revenue Cycle Management (RCM) refers to the rejection of a claim for reimbursement by a payer.
• Denials can occur for various reasons such as incorrect patient information, lack of pre-authorization, coding errors, or exceeding the coverage limit.

• Analyzing denial trends can help identify areas for improvement in the revenue cycle process.

• Effective denial management involves appealing denied claims, correcting ...read more
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Q2. What are five common denials in revenue cycle management (RCM)?
Ans. 
Common denials in revenue cycle management include lack of pre-authorization, coding errors, timely filing limits, duplicate billing, and non-covered services.
• Lack of pre-authorization for services

• Coding errors leading to claim denials

• Exceeding timely filing limits for claims submission

• Duplicate billing for the same service

• Services not covered by insurance
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