There is a detailed process that happens when a doctors office requests payment from an insurance company for a health insurance policy of one of their patients. Each visit or procedure must have claims paperwork submitted in order to get money. One cannot simply submit an invoice and expect to get paid. The health clinic, hospital, or doctors office must follow the procedure of the insurance provider to get a check.

Each procedure completed has a specific medical code that is assigned to it. When claims paperwork is filled out this medical code needs to be indicated on the forms, which are deciphered by the insurance company. If a code is not listed, no payment is sent whether or not the procedure was completed. This is why medical coders are often hired at doctors offices as they know the medical codes for procedures completed and how to fill out the paperwork so that they will get paid.

There is a time limit on filing a medical claim. If the claims paperwork is not done by the deadline, the insurance company will not pay. The doctor or hospital may then resort to asking you for payment. If they have submitted the claim late and the carrier will not pay then you should not be liable to the bill. Many companies will enter into contract agreements with doctors for rates on procedures and doctor visits. These agreements also include the time in which claims must be submitted.

When you make your first appointment, you will be asked to provide a picture identification and a copy of your insurance card which provides them with details of your health insurance policy features. This is needed to provide them with the information to file the claims to the insurance provider. Each time thereafter, they will ask you if your insurance is the same or if it has changed. You will only need to fill out new forms for a change in your insurance.

Once a claim has been filed to the insurance company, it will be processed and payment is issued to the requesting person or entity. The insurance company will provide a statement to the patient indicating how much was paid to the doctor which may include any copay amounts. If the money sent to the doctor office does not cover the full amount then the statement will detail any balance the patient will owe. An invoice is sent by the doctor's office to request payment from the patient for any remaining amount to close the bill. Claims paperwork plays a vital role in the doctors office. Health insurance companies require that they are filed to reimburse for patient care.