Which statement is true when determining patient financial responsibility by reviewing the remittance advice?

Which statement is true when determining patient financial responsibility by reviewing the remittance advice?

• A. The payer always covers the entire charge
• B. Remittance advice is not used for patient responsibility
• C. Any coinsurance, co-payments, or deductibles can be collected from the patient
• D. Remittance advice does not relate to patient bills

Answer: (C)

Reviewing the remittance advice shows how much the insurer paid and what portion the patient still owes. It breaks down patient financial responsibility into deductible, coinsurance, and copayment amounts. Those remaining amounts are what can be billed to the patient, so this document directly informs patient billing. The payer does not always cover the full charge, and the remittance advice is the source you use to determine patient liability. It is relevant to patient bills because it specifies exactly what the patient must pay.

Reviewing the remittance advice shows how much the insurer paid and what portion the patient still owes. It breaks down patient financial responsibility into deductible, coinsurance, and copayment amounts. Those remaining amounts are what can be billed to the patient, so this document directly informs patient billing. The payer does not always cover the full charge, and the remittance advice is the source you use to determine patient liability. It is relevant to patient bills because it specifies exactly what the patient must pay.