Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

An interim claim is submitted by a provider under which circumstance?

1. When the treatment is completed

2. When a patient is discharged

3. When a patient is still receiving services

4. When no services are rendered

The correct answer is: When a patient is still receiving services

An interim claim is submitted by a provider when a patient is still receiving services. This type of claim allows healthcare providers to receive partial payments for ongoing treatments instead of waiting until all services are completed. It is particularly useful in situations where treatment spans a long duration, such as with rehabilitation or long-term care. By processing interim claims, providers can maintain cash flow while continuing to deliver care. Submitting an interim claim recognizes that the patient has not yet completed their care, but the provider needs to be reimbursed for the services that have already been rendered. This practice also helps in managing the financial aspects of patient care more effectively, especially in cases involving chronic conditions or ongoing therapies.