Medical Insurance Claims Processing – A Case Study

Usually you will find people say health insurance claims process starts when you get treated by a doctor, this partly true because before claiming insurance and visiting a doctor, one should know about his insurance policy, what all is covered under the policy and to what extent. In short you should be clear about your health Insurance Policy.

Medical Claim Form

Then when you visit a doctor and treatment is given to you, a bill is prepared by the hospital or clinic’s staff which is then sent to Insurance company to get the claim amount.

But you have to process your claim, that is give the medical center store information about you and process your claim by forwarding it to insurance company, This can be done in two ways:

• Manually
• Electronically 

In manual processing the patient fills a printed medical claim form his insurance, the form is easily available from the Insurance Company’s website, and you have to fill all your details in the form, from personal details to the details about your treatment for them to check with the hospital and vice-versa.

Electronically is modern way of filling your claim form , instead of downloading and printing the form you can fill the form online and submit , here also all the details should be present

Electronic form filling is better as there are very less chances of error, also it is less time consuming too as you will get suggestions and shortcuts. We would ask you to prefer Electronic submission.

There is role of clearing houses also, there are lot claims every day from different hospitals to different insurance providers, so to make the process easy clearing houses were setup.

After claim form has reached the Insurance Company they verify it and provide you with the amount of claim.