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Basic Information On Medical Claims Processing A medical claim otherwise known as health insurance claim can be acquired in three ways: through the government, through the employer or an individual’s effort. 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 entire process of attaining medical care stress free and appropriate. 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 the work of the hospital to obtain payment for the medical bill through the insurance company or through the employer who can also be an 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 entire process of medical claim processing starts when the patient enters the hospital. The individual who is not feeling well is then invited to submit the health insurance card. They are then supposed to fill in a medical form that will provide the hospital with personal information about them. A person who is not feeling well will be called upon to present a government photo identification card for the purpose of proofing identity. When all the information has been verified the patient then receives treatment. After the medical service has been provided the hospital then documents all the billable services that the patient has received. The record of the medical services offered and the costs is what is called a medical claim.
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The information recorded is then directed to the insurance entity that has covered the person who is sick. The insurance entity then has three alternatives. 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 advantageous to the patient in that the patient can receive treatment whenever they are sick as long as they are insured. The whole process of making a medical claim is convenient to the hospital and the patient.