Automated Review is also known as what?

• A. Electronic Denials
• B. Clinical Review
• C. Technical Denials
• D. Manual Intervention

Answer: (C)

Automated Review is the system-driven check of claims and documentation for technical accuracy and data integrity. It looks for issues like missing required fields, invalid codes or modifiers, date mismatches, or payer-specific data problems. When these technical issues block payment, the denial type is called technical denials. This differs from clinical review, which focuses on medical necessity, and from manual intervention, which involves a person reviewing the case. Electronic denials describe how the denial is delivered, not the process being described.