The reimbursement process typically involves several steps:
1. Diagnosis and Treatment Plan: The healthcare provider diagnoses the patient and develops a treatment plan. 2. Pre-authorization: For many treatments, especially expensive ones like chemotherapy or radiation therapy, pre-authorization from the insurance company is required. 3. Service Delivery: The healthcare provider delivers the treatment or services. 4. Billing: The provider submits a claim to the insurance company, detailing the services provided. 5. Claims Processing: The insurance company reviews the claim and determines the amount to be reimbursed based on the patientâs coverage plan. 6. Reimbursement: The insurance company reimburses the healthcare provider, and any remaining balance may be billed to the patient.
