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How does my client's insurance company know to attribute what the client has paid me towards their deductible?

The Claims Cycle at a Glance

It can feel a bit like "magic" how the insurance company knows what happened in your office, but it follows a standardized data exchange:

  • Step 1: You collect the payment from the client based on their benefit verification.

  • Step 2: CCS submits a professional claim (CMS-1500) to the payer.

  • Step 3: The insurance company processes the claim and generates an Explanation of Benefits (EOB).

  • Step 4: This EOB officially attributes the amount to the client’s deductible, updating their remaining balance in the insurance system.