Insurance Claim Review

**Definition:** Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.

**Tree numbers:** - N03.219.521.576.215

**Synonyms:** - Claims Review - Insurance Claims Analysis - Claim Review, Insurance - Review, Insurance Claim - Analysis, Claims - Review, Claims - Claims Analysis