Which document communicates to the payer that the provider is requesting reimbursement?

The document that communicates to the payer that the provider is requesting reimbursement is the health insurance claim. This is a formal request submitted to the insurance company detailing the services rendered to a patient, including procedure codes and associated costs. When a healthcare provider submits a claim, it serves as an official notification that they expect payment for the services provided to the patient who is covered under the health insurance plan.

A health insurance claim includes essential information such as patient demographics, insurance details, and treatment information, allowing the payer to review the case and determine the eligibility for reimbursement. The proper submission of a claim is crucial in the billing process, as it initiates the payer's review and processing for payment.

The other documents mentioned do serve important purposes but do not directly request reimbursement in the same manner as the health insurance claim. For instance, an appeals letter is utilized when a provider disputes a denied claim, the explanation of benefits is a summary sent to patients detailing how their claims were processed and what amounts are covered, and the ledger card is an internal record of patient accounts and payment history maintained by the provider’s office. Each of these plays a role in the overall billing process, but the claim specifically initiates the request for reimbursement.