White paper explains use of mock claims for advanced explanation of benefits
The AHA Jan. 26 released a white paper on addressing challenges in implementing an advanced explanation of benefits, which requires coordination among multiple providers, health plans and IT systems. It highlights the use of a mock claim proposal, which uses the same electronic format providers already use to submit insurance claims to transmit good faith estimates to health plans. These estimates would be submitted as mock versions of real claims to estimate care costs, allowing health plans to process them using existing adjudication systems and generate an AEOB for patients. READ MORE
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