1.0Glossaryhttps://www.healthbenefitstimes.com/glossaryGlossaryhttps://www.healthbenefitstimes.com/glossary/author/adminglossary/Claims review - Definition of Claims reviewrich600338<blockquote class="wp-embedded-content" data-secret="OkhN4HBP0z"><a href="https://www.healthbenefitstimes.com/glossary/claims-review/">Claims review</a></blockquote><iframe sandbox="allow-scripts" security="restricted" src="https://www.healthbenefitstimes.com/glossary/claims-review/embed/#?secret=OkhN4HBP0z" width="600" height="338" title="“Claims review” — Glossary" data-secret="OkhN4HBP0z" frameborder="0" marginwidth="0" marginheight="0" scrolling="no" class="wp-embedded-content"></iframe><script>
/*! This file is auto-generated */
!function(d,l){"use strict";l.querySelector&&d.addEventListener&&"undefined"!=typeof URL&&(d.wp=d.wp||{},d.wp.receiveEmbedMessage||(d.wp.receiveEmbedMessage=function(e){var t=e.data;if((t||t.secret||t.message||t.value)&&!/[^a-zA-Z0-9]/.test(t.secret)){for(var s,r,n,a=l.querySelectorAll('iframe[data-secret="'+t.secret+'"]'),o=l.querySelectorAll('blockquote[data-secret="'+t.secret+'"]'),c=new RegExp("^https?:$","i"),i=0;i<o.length;i++)o[i].style.display="none";for(i=0;i<a.length;i++)s=a[i],e.source===s.contentWindow&&(s.removeAttribute("style"),"height"===t.message?(1e3<(r=parseInt(t.value,10))?r=1e3:~~r<200&&(r=200),s.height=r):"link"===t.message&&(r=new URL(s.getAttribute("src")),n=new URL(t.value),c.test(n.protocol))&&n.host===r.host&&l.activeElement===s&&(d.top.location.href=t.value))}},d.addEventListener("message",d.wp.receiveEmbedMessage,!1),l.addEventListener("DOMContentLoaded",function(){for(var e,t,s=l.querySelectorAll("iframe.wp-embedded-content"),r=0;r<s.length;r++)(t=(e=s[r]).getAttribute("data-secret"))||(t=Math.random().toString(36).substring(2,12),e.src+="#?secret="+t,e.setAttribute("data-secret",t)),e.contentWindow.postMessage({message:"ready",secret:t},"*")},!1)))}(window,document);
//# sourceURL=https://www.healthbenefitstimes.com/glossary/wp-includes/js/wp-embed.min.js
</script>
Review of claims by governments, medical foundations, PAROs, insures or other responsible for payment to determine liability and amount of payment. This review may include determination of the eligibility of the claimant or beneficiary; of the eligibility of the provider of the benefit; that the benefit for which payment is claimed is covered; that the benefit is not payable under another policy and that the benefit was necessary and of reasonable cost and quality.