A patient is registered in the system with his/her coverage details and then that patient’s treatments are entered and updated in the system. These claims need to be sent to the patient’s primary insurance.
This process of sending the charges to the patient’s Insurance Company is called Filing Claims.
A service performed by the physician and entered in the system is called Charge but when the same charge is filed to that patient’s Insurance Company, it is called Claim.
Claims may be sent in two ways:
Electronic claims are sent in ANSI/NSF Format. Paper claims are sent in CMS Forms-1500