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Lesson eight discusses claim problems and common error codes encountered in electronic claim processing. Claims are checked by practice management software before being sent to a Clearinghouse, which scrubs them before forwarding to the insurance payer. Payers have criteria for accepting claims, which then go through adjudication. Claims can be adjusted or denied due to coding errors, resulting in non-payment for providers. Resolving claim issues promptly is crucial to avoid delays in payment.
