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Understanding Medical Claim 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. If it is through the employer, the employer chooses the insurer and the policy plan for the employee. At the end of every month the employer deducts some amount from the employee’s salary to cater for the insurance. If it is through individual initiative and the individual approaches an insurance company and then pays insurance policy to obtain the insurance policy. If it is through the government it is often at a subsidized price. When the month expires some money will be taken out from the salary of that person to cater for 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 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. It entails some certain processes before the hospital can be refunded the amount that the patient has used on medication. The the whole procedure of medical claim processing begins when the patient gets to the health care facility. The patient is then requested to hand in their medical card. The patient is then required to fill up a health form that will give the hospital personal information regarding them. An individual who is ailing will be requested to hand in a government photo identification card that will act as evidence of their true identity. Once the whole information has been approved the individual who is not feeling well is the treated. 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 information noted down regarding the medical services given and the expenses incurred is better known as health insurance 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. One is to verify the information that the hospital has sent and then reimburse the hospital. The second thing to do after looking into the information that has been given and finding that it is untrue is to throw away the claim for compensation.
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Medical claims are of great benefit to the person who is sick because they can be treated when they are not feeling well provided they are covered. The whole procedure of making a medical claim is appropriate for both the hospital and the patient.