What happens to claims after a clearinghouse has reviewed them for errors?

Prepare for the Mobius Institute Board of Certification (MIBoC) Exam. Utilize flashcards and multiple choice questions each with hints and detailed explanations. Equip yourself with the knowledge to excel in your certification!

After the clearinghouse has reviewed the claims for errors, the correct process involves sending the claims to the proper insurance carrier. This step occurs once the claims are verified and deemed free of critical errors that would prevent them from being processed. The role of the clearinghouse is to facilitate the submission of claims by acting as an intermediary, ensuring that the claims meet the necessary requirements before they are forwarded to the relevant insurance carrier for payment processing.

The alternative choices present distinct scenarios that do not accurately reflect the typical operational flow in the claims processing landscape. Automatic approval for payment implies that no further review is conducted, which is not the case as clearinghouses primarily focus on validating claims rather than authorizing payments. Sending claims back to the provider for corrections would only take place if errors were detected during the review, which is not the primary function of a clearinghouse after their review process. Finally, discarding claims does not align with the clearinghouse's responsibility, as their purpose is to manage and streamline claims submission rather than eliminate them.

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