Question

This concept encompasses all activities required to send a request for payment to a third-party health plan for payment of benefits

a) Patient engagement
b) Claims processing
c) Supply chain management
d) Quality assurance

Answer 1

Claims processing encompasses all activities required to send a request for payment to a third-party health plan for payment of benefits.

Step-by-step explanation:

The concept that encompasses all activities required to send a request for payment to a third-party health plan for payment of benefits is Claims processing.

Claims processing involves the submission, processing, and adjudication of claims for medical services provided to patients. This includes verifying patient eligibility, coding diagnoses and procedures, calculating reimbursement amounts, and managing the payment process.

For example, when a patient receives medical treatment, the healthcare provider submits a claim to the patient's health insurance company for payment. The claims processing system then reviews the claim, verifies the information, and determines the amount of reimbursement based on the patient's benefits and the provider's services.