Certified Clinical Medical Assistant Exam Practice Question

Correct Answer: D

Rationale: An insurance claim may be denied if it is submitted before the effective date of coverage (Option D), as the policyholder is not yet eligible for benefits.

Option A, prior authorization obtained, typically supports a claim rather than leads to denial, indicating that the insurer approved the treatment beforehand. Option B, medical necessity determined, also favors claim approval, as it shows the service was deemed essential for the patient's health. Lastly, Option C, allowable charge met, means the service cost falls within the limits set by the insurer, further supporting the claim rather than denying it.