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A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [2] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4]
An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes:
Established in 1970 as a non-profit organization, ACORD was formed by insurance carriers and agents focused on building efficiencies in the United States property casualty insurance market. Originally named Agent Company Operations Research and Development (ACORD), the organization's initial goal was to standardize the many proprietary forms ...
A new year often means adjusting to a new health insurance plan with a different set of benefits and costs. Those on Medicare aren't exempt from this. Original Medicare's cost and coverage change ...
The process varies from provider to provider, but how you file a car insurance claim usually begins with a phone call, filling out an online form or using your insurance company’s app to begin ...
Blue Cross Blue Shield insurers offer some form of health insurance coverage in every U.S. state, and also act as administrators of Medicare in many states or regions of the United States, and provide coverage to state government employees as well as to federal government employees under a nationwide option of the Federal Employees Health ...
A substitute check (also called an Image Replacement Document or IRD) [1] is a negotiable instrument that is a digital reproduction of an original paper check.As a negotiable payment instrument in the United States, a substitute check maintains the status of a "legal check" in lieu of the original paper check, as authorized by the Check Clearing for the 21st Century Act (the Check 21 Act).
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