CPB (Certified Professional Biller) Certification Practice Exam

Which document communicates to the payer that the provider is requesting reimbursement?

1. Health Insurance Claim

2. Food Order Receipt

3. Hotel Reservation Confirmation

4. Movie Ticket Stub

The correct answer is: Health Insurance Claim

The health insurance claim is the document specifically designed to communicate to the payer that the provider is requesting reimbursement for services rendered to a patient. This claim contains essential information such as the patient's demographic details, the services provided, associated diagnosis codes, and the provider's billing information. The claim form serves as a formal request from the healthcare provider to the insurance company or payer, detailing what services were performed and why payment is warranted. It is structured to meet the requirements of the payer for processing claims and ultimately facilitates the reimbursement process. On the other hand, the other choices do not serve this purpose. A food order receipt, a hotel reservation confirmation, and a movie ticket stub do not pertain to healthcare services or reimbursement requests. They are related to different industries and transactions entirely, lacking the necessary information required for healthcare billing.