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Claim status codes

National administrative code set that identifies the status of health care claims. This code set is used in the X12 277 claim status notification transaction and is maintained by the Health Care Code Maintenance Committee.

Claim-Made basis (Policy attaching basis)

A form of reinsurance under which the date of claim reported is deemed to be the date of the loss event. Claims reported during the term of the reinsurance agreement are therefore covered, regardless of when they occurred. A claims made agreement is said to “cut of the tail” on liability business by not covering claims reported after the term of reinsurance agreement – unless extended by special agreement. See. Occurrence basis.

Claimant

MEDICAL,USA: Insured individual or beneficiary who makes a formal request for payment of insurance benefits because of illness or injury that meets the terms of an insurance contract. This individual could be a provider or legal representative of the insured who makes a claim to an insurance plan.
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The first or third party. That is any person who asserts right of recovery.
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The individual requesting payment of a claim.
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The person making a claim.
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US: The person making a claim. Use of the word “claimant” usually denotes that the person has not yet filed a lawsuit. Upon filing a lawsuit, claimant becomes a plaintiff, but the terms are often used interchangeably.
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The person making a claim. Use of the word &#8220claimant&#8221 usually denotes that the person has not yet filed a lawsuit. Upon filing a lawsuit, claimant becomes a plaintiff, but the terms are often used interchangeably.