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Basic Information On Medical Claims Processing A medical claim better known as a health insurance claim can be gained in three ways: through the government, through the employer or one’s determination. When it is through the employer; the employer selects the insurer and the policy plan for the employee. When the month expires the employer takes away some money from the employee’s salary to cover the insurance. When it is through a person’s own effort the person approaches an insurance firm and pays for the insurance policy so that they can be given the insurance policy. If it is through the government it is often at a subsidized price. When the month ends some money will be subtracted from the salary of an individual to cover the insurance. Medical claims have made the full procedure of gaining medical care relaxed and opportune. In the occasion that one’s health worsens they can go to a health care facility and receive treatment without being charged anything. It is then upon the health care provider to demand payment for the medical service from the insurance firm or from the employer who may also be the insurer. There are certain procedures that need to be followed before the health care facility can be compensated the money that the insured has consumed in order to receive treatment. The full procedure of health insurance claim processing commences when the insured reaches the health care facility. The a person who is sick is requested to give their insurance card. They are then supposed to fill in a medical form that will provide the hospital with personal information about them. The patient is also required to present a government photo identification card for identification purposes. When all the information has been verified the patient then receives treatment. When the medical service has been given the health care facility will note down all the services that are supposed to be charged that the insured has been given. The documentation of the medical services offered and the charges is what is known as a medical claim.
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The record is then sent to the insurance company that has covered the patient. The insurance company then has three options. First is to look into the information that the health care facility has provided has delivered and then compensate the health care facility. The second thing they do is when they verify the information and find some false statement they refuse to reimburse the hospital.
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Medical claims are of benefit to the individual who is ailing in the sense that they can be treated when they are not feeling well provided they are insured. The whole procedure of making a medical claim is appropriate for both the hospital and the patient.