Claims processing involves several key steps: 1. Claim Submission: The healthcare provider submits the claim to the insurance company. 2. Adjudication: The insurance company reviews the claim to determine payment eligibility according to the patient's policy. 3. Payment: If approved, the insurance company disburses the payment to the healthcare provider. 4. Denial Management: If a claim is denied, the provider must identify the reason, correct any issues, and resubmit the claim.
