Legal Definitions - healthcare-insurance receivable

A healthcare-insurance receivable refers to the legal right a healthcare provider has to receive payment from an insurance company for medical services or goods that have already been provided to a patient. It represents a claim against an insurance policy for a specific monetary amount due after care has been delivered.

• Example 1: Hospital Emergency Care

  Imagine a patient visits a hospital emergency room after experiencing chest pains. The hospital provides immediate medical attention, including diagnostic tests, consultations with specialists, and medication. After the patient is stabilized and discharged, the hospital compiles all the charges for the services rendered and submits a claim to the patient's health insurance company. The hospital's legal right to receive payment from that insurance company for the emergency care provided is considered a healthcare-insurance receivable.

• Example 2: Physical Therapy Sessions

  Consider a patient who undergoes several weeks of physical therapy at a specialized clinic to recover from a sports injury. Each therapy session involves specific exercises and treatments. The physical therapy clinic meticulously records these services. At the end of the treatment plan, or at regular billing intervals, the clinic sends an invoice to the patient's health insurer. The money the clinic expects to receive from the insurance company for those completed therapy sessions represents a healthcare-insurance receivable.

• Example 3: Diagnostic Laboratory Services

  A doctor orders a series of blood tests for a patient during a routine check-up. The patient visits an independent diagnostic laboratory to have the blood drawn and analyzed. Once the lab completes the analysis and sends the results to the doctor, the laboratory prepares a bill for its services. The lab then submits this claim directly to the patient's health insurance provider. The diagnostic laboratory's entitlement to be paid by the insurance company for performing those blood tests is a healthcare-insurance receivable.