What is “pending claim” in medical billing?

Pending Claim in Medical Billing

A pending claim is a claim that has been submitted to the insurance company but has not yet been fully processed or approved for payment.

Pending Claim in Medical Billing Explained

In medical billing, claims remain in a pending status while the insurance company reviews the claim for accuracy, coverage, and medical necessity. Pending claims may require additional information before they are processed.

For example, a claim is pending while the insurance company requests more documentation about the procedure performed.

Learn more about common acronyms and abbreviations in Medical billing glossary.

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