Outpatient claims are medical bills containing all services and care the patient received from a facility without partaking in an overnight stay. The outpatient’s insurance provider then assesses the medical codes to determine the reimbursement amount for the provider for their services. Based on this, outpatient claims are a crucial step for compensating facilities services they provide.
Those with Medicare Part B cover many diagnostic and treatment services received as an outpatient from a Medicare-participating hospital. The hospital will file the claim with Medicare, and then Medicare will pay them their reimbursement directly.