Non-Medical Record Review involves which of the following?

Non-Medical Record Review involves which of the following?

• A. Manual Intervention to obtain additional documentation
• B. Automated processing of claims without human input
• C. Reviewing medical necessity decisions
• D. Only audits the payment amounts

Answer: (A)

Non-Medical Record Review centers on actively obtaining missing documentation from sources outside the patient chart, which almost always requires a person to intervene. This manual outreach to gather external records, notes, or documents is what fills gaps and supports accurate coding and documentation. Automated processing without human input wouldn’t involve collecting additional documents, so it doesn’t fit. Reviewing medical necessity decisions is a clinical review focused on justification for care, not on obtaining non-clinical records. Auditing payment amounts is about financial aspects rather than gathering supplemental documentation.

Non-Medical Record Review centers on actively obtaining missing documentation from sources outside the patient chart, which almost always requires a person to intervene. This manual outreach to gather external records, notes, or documents is what fills gaps and supports accurate coding and documentation.

Automated processing without human input wouldn’t involve collecting additional documents, so it doesn’t fit. Reviewing medical necessity decisions is a clinical review focused on justification for care, not on obtaining non-clinical records. Auditing payment amounts is about financial aspects rather than gathering supplemental documentation.