How Does A Health Insurance Claim Work? 
After you are treated by a provider , a billing statement is sent to the insurance company . Typically , a claims approver -LRB- sometimesit is handled electronically -RRB- will review the submitted claim and determine if it is covered , and how much of the claim will be paid by the insurer . That amount is paid and any balance is now the responsibility of you ... the insured . Of course , hopefully , it is a small amount ! Our job , as brokers , is to help you find plans that keep your obligation of the bill as low as possible . 