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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]
Combined Insurance is a global provider of supplemental insurance, including accident insurance, life insurance and critical care coverage. Combined Insurance operates in North America, Latin America, Europe and the Pacific. The company is headquartered in Chicago, Illinois.
In insurance, the insurance policy is a contract (generally a standard form contract) between the insurer and the policyholder, which determines the claims which the insurer is legally required to pay. In exchange for an initial payment, known as the premium, the insurer promises to pay for loss caused by perils covered under the policy language.
For example, with a deductible of 10% with a minimum of $1,500 and a maximum of $5,000, a claim of $25,000 would incur a deductible of $2,500 (i.e. 10% of the loss), and the resulting payment would be $22,500. A claim below $15,000 would incur the minimum deductible of $1,500, and a claim above $50,000 would incur the maximum deductible of $5,000.
Insurance companies themselves, as well as self-insuring employers, purchase stop-loss coverage for a premium to protect themselves. [1] In the case of a participant reaching more than the specific (or "individual") stop-loss deductible ($300,000, for example), the insurer will reimburse the insured (the company, not the participant) for the remainder of the claim to be paid over that ...
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Liability insurance (also called third-party insurance) is a part of the general insurance system of risk financing to protect the purchaser (the "insured") from the risks of liabilities imposed by lawsuits and similar claims and protects the insured if the purchaser is sued for claims that come within the coverage of the insurance policy.
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