Revenue Cycle Management Specialist (RCMS) Practice Exam

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Under the Administrative Simplification Compliance Act (ASCA), claims must be sent electronically unless unusual circumstances are met. Which statement best describes this requirement?

Claims may be submitted on paper for all providers.

Claims must be sent electronically unless unusual circumstances are met.

Electronic submission of claims is required under ASCA, with paper submissions allowed only when unusual circumstances prevent electronic transmission. This means providers should file claims electronically using standard formats (like 837) to improve speed and accuracy, and only in cases where the payer cannot accept electronic submissions or the provider lacks the necessary capability (or during a temporary system outage) would paper be appropriate. The other options imply paper is always or never allowed, which conflicts with ASCA’s allowance for documented exceptions.

Paper submissions are required for most claims.

Paper submission is never allowed.