When reviewing a delinquent claim, what action should be taken first?

When reviewing a delinquent claim, what action should be taken first?

• A. Verify the age of the account
• B. Submit the claim again electronically
• C. Notify the patient
• D. Cancel the claim

Answer: (A)

When a claim is delinquent, the first step is to confirm how old the account is. Checking the aging status tells you exactly how long the claim has been outstanding and what the next appropriate action should be under payer guidelines. This verification helps you determine whether the claim is truly awaiting payment, requires additional information, is within a permissible resubmission window, or needs a different follow-up path. Taking this initial, factual step prevents duplicating submissions, guides you to the correct outreach (such as gathering missing data or preparing for payer status checks), and sets up clear next actions. Proceeding to resubmit without checking the account age can create duplicates or premature requests. Alerting the patient without confirming payer status can lead to confusion later, and canceling the claim is not appropriate as the first action—it should come only if the claim is invalid or a payer directs cancellation after reviewing the account.

When a claim is delinquent, the first step is to confirm how old the account is. Checking the aging status tells you exactly how long the claim has been outstanding and what the next appropriate action should be under payer guidelines. This verification helps you determine whether the claim is truly awaiting payment, requires additional information, is within a permissible resubmission window, or needs a different follow-up path. Taking this initial, factual step prevents duplicating submissions, guides you to the correct outreach (such as gathering missing data or preparing for payer status checks), and sets up clear next actions.

Proceeding to resubmit without checking the account age can create duplicates or premature requests. Alerting the patient without confirming payer status can lead to confusion later, and canceling the claim is not appropriate as the first action—it should come only if the claim is invalid or a payer directs cancellation after reviewing the account.