Claim

A Claim is a request for payment sent to an insurer or payer after health care services have been performed.
A Claim is created by the receiving or performing/billing provider. This provider is responsible for billing because they delivered the service, incurred the associated costs, and are entitled to claim reimbursement.
The referee may include the patient’s insurance information and coverage; however, the referee does not verify coverage for the specialist service and does not check eligibility for services offered by the receiving provider.