Question

multiple choice question

when a payer approves the service, it issues a ______ number.

verification of benefit
benefit
referral
prior authorization

Explanation:

Analyze the question stem

The question asks for the specific term that completes the sentence: "When a payer approves the service, it issues a ________ number."

Evaluate the options using medical billing concepts

Using the Prior Authorization knowledge point

• verification of benefit: This is the process of verifying what services are covered under a patient's insurance plan, but it does not generate an approval number for a specific service.
• benefit: This refers to the healthcare items or services covered under a health insurance plan.
• referral: This is a recommendation from a primary care physician for a patient to see a specialist.
• prior authorization: When an insurance company (payer) approves a requested medical service, treatment plan, or prescription drug before it is received, it issues a unique prior authorization number (also known as a certification number) to prove approval.

Answer:

• verification of benefit
• benefit
• referral
• prior authorization (Correct answer)