Claims Processing in Health Insurance Checklist

Summary

This Claims Processing in Health Insurance Checklist provides guidance on addressing claims processing issues arising in commercial health insurance. The issues may involve defining a claim, understanding the claims processing timeline and claim forms, and identifying and researching applicable law. Specifically, this checklist will help you to better understand your client's claim processing obligations and how to identify laws, regulations, and administrative rules governing that process. It does not address appeals of claims denials.