Which feature is used to create two separate claims for the same payer with some charges on one claim and other charges on the other?

• A. Claim Split
• B. Batch Split
• C. Duplicate Claims
• D. Payer Isolation

Answer: (A)

This tests how to separate charges for the same payer by splitting a single claim into two. A claim split lets you take the line items from one encounter and create two separate claims for the same payer, placing some charges on one claim and the remaining charges on the other. This is useful when payer rules or billing needs require different processing for different parts of a visit—such as services dated or billed separately, or charges that must be handled with different pricing or benefit rules—while keeping everything linked to the same patient, provider, and encounter.

Other options don’t fit the scenario: batching would split at the batch level, not the individual claim’s line items; duplicating claims would send two identical claims; and payer isolation isn’t the mechanism for dividing charges across two claims.