What is the process called for transmitting claims data to payers or clearinghouses?

The process of transmitting claims data to payers or clearinghouses is referred to as submission. This stage is crucial in the billing cycle, as it involves sending the completed claim forms, which contain details about the patient, provider, and services rendered, to the respective payer or an intermediary called a clearinghouse.

The submission process ensures that all necessary information is accurately conveyed and formatted according to the requirements of the payer, which assists in expediting the claims review and approval process. Successful submission of claims is critical for timely reimbursement and helps to minimize errors and denials often encountered in the claims lifecycle.

In contrast, assignment refers to the patient allowing the provider to bill insurance on their behalf, adjudication is the review process carried out by the payer to determine the payment responsibility, and processing is a broader term that can encompass all activities involved in handling the claim after submission.