What is necessary for a health insurance claim to be processed?

For a health insurance claim to be processed, a claim form and supporting documentation are essential. The claim form serves as a formal request for payment to the insurer, detailing the services rendered, the diagnosis, and the patient's information, among other data. Supporting documentation, which often includes itemized bills, medical records, or a description of the services provided, is critical for the insurer to confirm the validity of the claim and to determine the accurate reimbursement amount.

Verbal reports from providers, while they may be useful in some contexts, do not meet the necessary documentation standards required for processing claims. Similarly, approval from an insurance company's board is not a requirement for processing individual claims; this would be more relevant in large-scale policy or procedural changes. A pre-authorization slip may be needed for certain procedures or treatments before they are performed, but it alone does not suffice for processing the overall claim post-treatment. Thus, the combination of a claim form and supporting documentation is fundamental for a claim to be evaluated and paid by the insurer.