Claim: An itemized statement of healthcare services and their costs provided by a hospital, physician's office, or other provider facility. Claims are submitted to the insurer or managed care plan by either the plan member or the provider for payment of the costs incurred.

 

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Claim: An itemized statement of healthcare services and their costs provided by a hospital, physician's office, or other provider facility. Claims are submitted to the insurer or managed care plan . . . View Full Definition

Disclaimer Of Opinion: An order terminating a lien on property.

Claimant: The person or entity submitting a claim.

Claims Administration: The process of receiving, reviewing, adjudicating, and processing claims.

Claims Investigation: The process of obtaining all the information necessary to determine the appropriate amount to pay on a given claim.

Marketed Claims: Claims that can be bought and sold in financial markets, such as those of stockholders and bondholders.

Nonmarketed Claims: Claims that cannot be easily bought and sold in the financial markets, such as those of the government and litigants in lawsuits.

Residual Claim: Related: Equity claim

Claim Status: Claims are Paid, Pended, Denied, or Received-Not-Yet-Processed.

Denied Claim: Claims that are not issued a bank draft/remittance due to a specific reason code.