Which process involves transmitting claims data to payers for processing?

The process of transmitting claims data to payers for processing is known as Claims Submission. This is a critical step in the healthcare reimbursement process, where healthcare providers send the necessary information about services rendered to patients, along with costs, to insurance companies or other payers.

During Claims Submission, details such as diagnosis codes, procedural codes, and patient information are compiled into a claim form and sent electronically or via paper to the payer, who will then review and process these claims.

In contrast, Claims Processing refers to the actual review of the submitted claim by the payer to ensure that the information provided aligns with their policies for coverage and payment. Claims Adjudication follows processing and involves the decision-making phase where claims are either approved or denied based on the eligibility and terms of the payer's agreement with the healthcare provider. Claims Review is an additional level where claims may be evaluated for accuracy or compliance with legal and regulatory standards, but it does not specifically encompass the act of sending or submitting the initial claim data.

Therefore, Claims Submission is the correct term for the action of sending claims data to payers, as it specifically focuses on the initial step of communicating and delivering claims for further processing and payment decisions.