With documents like these, your claim would be approved
All required details should be included:
- Name of provider
- Name of patient (who received the item/service)
- Description of service
- Date of service (not date payment was made)
- Amount charged (not amount paid as this could differ from amount charged for eligible service/item)
The receipt examples above include all required information for claim approval, including (1) name of the provider, (2) who received the service, (3) description of service, (4) date of service, (5) and cost.
With documents like these, your claim would be denied
Some of the required details are missing. Here are some quick tips:
- Make sure the date is the date of service, not the date payment was made.
- If the claim is for a range of dates (7 weeks, for example), the document must show detail for each week.
- Double-check that the name of the person who received the service is included, not the name of the account holder, unless it is the same person.
- Please remember amount paid is not equal to amount charged. The document must show amount charged for the eligible service/item. Amount charged (not amount paid as this could differ from amount charged for eligible service/item).
This document is missing date of service, description of services and amount charged for eligible item/service.
This example is missing name of patient, description of service and date of service.
This claim would also require a letter of medical necessity to be approved.
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