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300 S. Park Ave, Ste. 903
Pomona, CA 91766

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California Insurance Blog

Health Insurance – The Claims Process Explained

Health insurance claims reimburse a patient for services that a medical practitioner rendered. Learn some basics about the claims process. Then, consult one of our THINK Insurance & Financial Services agents if you want additional information about your insurance policy.

Direct Billing

When a medical provider within your network sees you, you will receive a bill listing the medical procedures performed. A representative of the medical facility will submit the bill to your insurance provider. The bill will contain codes that relate to the types of procedures that were performed. 

Individual Claim

If you are seen by a medical provider outside your network, you may be responsible for filing your own insurance claim.

Typically, you can file a claim online. You will simply need to do this through your insurance provider’s website. You can also fill out a paper claim form and send it to your insurance provider.

Claims Process

The claims process requires reviewing the bill or claim information. During this process, whether you are approved or denied for the claim will be determined.

If you are approved for the claim, you will be reimbursed for out-of-pocket costs that you were responsible for after the medical services were rendered. You may receive a full or partial reimbursement for the amount you paid.

Policy Assistance

You may have additional questions or concerns about health insurance claims. Each billing process is unique and will be personalized based on the services you have received. One of our agents, who serves Pomona, CA, can help you with any issues you have with your insurance policy. Give one of our agents a call today.

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