Claims processing

Claims submission, processing, adjudication and payment have become increasingly complex and present a significant administrative and technological challenge for physician offices. However, it is critical that physicians and their office staff understand these processes to ensure proper payment for services and to detect improper reimbursement practices.

The AMA's Private Sector Advocacy (PSA) unit has developed the following tools (some are PDF files; require Adobe Acrobat Reader) to help physicians navigate the maze of the claims submission process: