What are the two main categories of payment denial reasons commonly encountered in medical billing?

• A. Technical errors and incorrect or incomplete information.
• B. Patient age and gender.
• C. Insurer address and phone number.
• D. Provider specialty and location.

Answer: (A)

When medical billing denials occur, they most often fall into two broad types: technical errors in the claim submission and incorrect or incomplete information on the claim. Technical errors involve problems with how the claim is transmitted or processed by the payer—missing required fields, incorrect file format, or invalid identifiers. These issues stop the claim from being adjudicated until the submission is corrected and resubmitted. Incorrect or incomplete information covers mistakes in the data on the claim or missing documentation to support payment—such as wrong dates of service, mismatched procedure or diagnosis codes, lack of medical necessity documentation, or missing prior authorization. Correcting the data or providing the needed documentation allows the claim to be refiled for consideration.

The other choices don’t fit as common denial categories because patient age and gender, or insurer address and contact details, or provider specialty and location don’t represent the typical root causes driving denials in routine medical billing.