Understanding Health Care Insurance Receivable: A Legal Perspective

Definition & Meaning

Health care insurance receivable refers to the right to receive payment from an insurance policy for health care services rendered or to be rendered. This term encompasses claims for reimbursement related to medical goods or services provided to patients. Essentially, it represents an asset for health care providers, indicating that they are owed money from insurance companies for the services they have delivered.

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Real-world examples

Here are a couple of examples of abatement:

Example 1: A hospital provides surgery to a patient and files a claim with the patient's insurance company for reimbursement. The amount owed to the hospital becomes a health care insurance receivable.

Example 2: A physical therapy clinic treats a patient over several sessions and submits claims for each session to the patient's insurance provider, establishing a receivable for the services rendered. (hypothetical example)

State-by-state differences

Examples of state differences (not exhaustive)

State Key Differences
California Specific regulations on billing practices and insurance claims.
Texas Different requirements for submitting claims and timelines.
New York State laws may affect the collection practices for receivables.

This is not a complete list. State laws vary and users should consult local rules for specific guidance.

Comparison with related terms

Term Definition Difference
Accounts Receivable Money owed to a business for goods or services provided. Broader category; includes all types of receivables, not just health care.
Insurance Claim A request for payment based on a policy. Refers to the action taken, while receivable refers to the right to payment.

What to do if this term applies to you

If you are a health care provider dealing with insurance receivables, ensure that you have proper documentation of services provided and claims submitted. Utilize legal form templates from US Legal Forms to streamline your billing process. If you encounter disputes or complex issues, consider seeking professional legal assistance.

Quick facts

  • Typical fees: Varies by provider and service.
  • Jurisdiction: Governed by state and federal insurance laws.
  • Possible penalties: May include fines for improper billing practices.

Key takeaways

Frequently asked questions

It is the right to receive payment from an insurance company for health care services provided to a patient.