Majority of the payment for medical services

Majority of the payment for medical services

Health insurance companies provide the majority of the payment for medical services that clinics and physicians deliver. After the care has been delivered, the medical record is reviewed for completeness, codes are applied, and the billing office submits the claim to the third-party payer or insurance company for payment. Discuss the following:

  • What does it mean to submit a clean claim?
  • State various reasons for the importance of a clean claim submission.
  • Address the consequences of not submitting a clean claim.
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