Which document serves as an explanation for an insurance claim payment?

The document that serves as an explanation for an insurance claim payment is the remittance advice. This document is provided by the insurance company to the healthcare provider after a claim has been processed. It details which services were covered, the amount paid, and any adjustments or denials that are applied to the claim.

Remittance advice is important because it helps healthcare providers understand how the claim was processed, what they can expect to receive in payment, and any reasons for denied or reduced payments. This information is essential for accurate financial management within a healthcare practice, as it allows providers to follow up on claims as necessary.

In contrast, other documents such as billing statements and claim forms serve different purposes. Billing statements summarize the amounts owed by patients for services rendered, while claim forms are used to initiate the claim process by capturing the necessary information about the patient and services provided. Policy guidelines outline the terms of coverage but do not provide a payment explanation.