Which field is used to record how much has already been paid by the payer?

Which field is used to record how much has already been paid by the payer?

• A. Total charges
• B. Health Plan ID
• C. Prior payments
• D. NPI

Answer: (C)

The field that records prior payments shows how much the payer has already paid toward the claim. This keeps track of payments made before the current submission, separate from the total amount billed. It helps determine what portion remains due and ensures accurate posting on the claim and in remittance. The total charges amount is what was billed, not what has been paid; the Health Plan ID identifies the insurer, and the NPI identifies the provider, neither of which reflect payment history. For example, if services total $1,000 and $600 has already been paid by the payer, the prior payments field will reflect $600 to guide processing of the remaining balance.

The field that records prior payments shows how much the payer has already paid toward the claim. This keeps track of payments made before the current submission, separate from the total amount billed. It helps determine what portion remains due and ensures accurate posting on the claim and in remittance. The total charges amount is what was billed, not what has been paid; the Health Plan ID identifies the insurer, and the NPI identifies the provider, neither of which reflect payment history. For example, if services total $1,000 and $600 has already been paid by the payer, the prior payments field will reflect $600 to guide processing of the remaining balance.