This problem requires a Pro subscription. Upgrade to access all 15 industry domains and 1,500+ questions.
Upgrade to ProYou are a Claims Integrity Auditor at Cigna. During adjudication, the total billed amount on the claim header should match the sum of billed amounts on the individual line items. Discrepancies may indicate data entry errors, unbundled services, or potential fraud. The audit team needs a report showing every claim along with the number of line items, the header-level billed amount, the sum of line-item billed amounts, and the variance between them — sorted by the largest absolute variances first.
You are a Claims Integrity Auditor at Cigna. During adjudication, the total billed amount on the claim header should match the sum of billed amounts on the individual line items. Discrepancies may indicate data entry errors, unbundled services, or potential fraud. The audit team needs a report showing every claim along with the number of line items, the header-level billed amount, the sum of line-item billed amounts, and the variance between them — sorted by the largest absolute variances first.