The Advanced EClinical Training Practice Test

Reviewing in medical billing means carefully checking the codes on a claim—the diagnostic codes that describe the patient’s condition and the procedure codes that describe the services provided—to confirm they accurately reflect the chart and will be reimbursed by the payer. This coding review ensures medical necessity, correct code assignments, and proper use of modifiers, which helps prevent denials or reduced payments and supports accurate reimbursement. Verifying patient identity is important for eligibility and access, but it isn’t about validating the coding that determines payment. Auditing claims is a broader activity that can occur after submission to assess compliance and performance, whereas reviewing focuses specifically on the accuracy of the coding that drives payment. Collecting patient payments is a separate financial task, not part of the code-review process.