Where should claims be sent for processing?

Claims should generally be sent to a fiscal intermediary or a local department of social services because these entities serve as the bridge between healthcare providers and government or insurance payers. Fiscal intermediaries manage the processing of claims for Medicare and Medicaid, ensuring that they are properly reviewed and reimbursed according to the guidelines set by these programs. They are specifically equipped to handle claims submitted under the regulatory framework of these federally funded programs, which often have unique requirements compared to private insurance.

Sending claims directly to a billing service or the hospital's accounting department may not ensure proper processing, as these parties may not have the same authorization or capability to interface directly with government insurance programs. Claims submitted to insurance agents may also not be processed efficiently for reimbursement. Therefore, the appropriate route is to send claims to a fiscal intermediary or the relevant department that oversees social services, ensuring compliance and optimized reimbursement for the services rendered.