Type of hospital invoice (patient’s financial accounting statement) assessed by someone auditing a hospital bill that has no errors. Also see under bill and over bill.
Tag: MEDICAL
Clean claim
Completed insurance claim form submitted within the program time limit that contains all the necessary information without deficiencies so that it can be processed and paid promptly; a claim that passes all electronic claim edits and claim audits; or a claim that is subject to medical review but is submitted with complete data attached or forwarded simultaneously with electronic media claim records.
Clean-up fund
Lump-sum type of life insurance death benefit to assist in paying the insured’s outstanding debts, funeral expenses, and related expenses—in other words, “cash” to clean up expenses.
Clearinghouse
Independent organization that receives electronically transmitted insurance claims from the physician’s office, performs software edits, routes, and transmits the claims to various insurance carriers. Also see health care clearinghouse.
Clerical error
Minor omission or error in form or content on Medicare Part A or Part B claims, such as missing data items (provider number or date of service). Omissions do not include failure to bill for certain items or services or third-party payer errors.
Clerical error provision
Insurance policy condition that if a person is eligible and submits a written request for coverage, he or she will not be denied coverage if the policyholder fails to give proper notice to the insurance company because of a clerical error.
Clerk
See: insurance billing specialist .