What are the Steps in the Claims Management Process?
The claims management process typically involves the following steps:
Claim Submission: The healthcare provider submits the claim to the insurance company. Claim Processing: The insurance company reviews the claim for accuracy and completeness. Adjudication: The insurance company decides whether to approve or deny the claim. Payment: If approved, the insurance company reimburses the provider. If denied, the provider may need to resubmit or appeal the claim.
