explanation of benefits
A document detailing services billed and describing payment determinations
A request for payment by asking for a review of an insurance claimthat has been inadequently or incorrectly paid or denied by an insurance company.
denied paper or electronic claim
one that may be denied because of beenfits coverage policy issues or program issues
a written request made to an insurance company to locate the status of an insurance claim
An insurance claim that cannot be located after sending it to an insurer
Money paid over and above the amount due by the insurer or patient
an evaluation done by a group of unbiasedpracticing physicians to judge the effectiveness and efficiency of professional care rendered
to send another request for payment of an overdue bill
a submitted claim that does not follow specific third-party payer instructions or contains a techical error
an explanation of benefits transmitted electronically by a payer to a provider.
to look over a claim to assess how much payment should be made
An insurance claim that is processed by the insurance carrier but held in an indeterminate (pending) state about payment either because of an error or the need for additional information.
the pending intermediate state of an insurance claim because of an error or need for more information
an inquiry made to an insurance company to locate the status of an insurance claim