Certified Outpatient Coder (COC) Practice Exam

The abbreviation RTP refers to "Return to Provider." This means that the claim must be returned to the provider for correction. This designation typically occurs when there are issues with the claim that need to be addressed before it can proceed through the payment process. This could include missing documentation, errors in coding, or other inaccuracies that prevent the claim from being processed as it stands.

In contrast, other options imply different statuses of the claim. "Ready to process" would signify that the claim meets all necessary criteria to move forward, which is not applicable in the case of an RTP designation. "Pending review" suggests that the claim is under examination but has not yet been returned, whereas "approved for payment" indicates that the claim has been accepted and is set for payment, which also does not align with an RTP situation. Thus, RTP clearly indicates a need for action on the provider's part to correct the information before further processing can occur.