Looking at a scenario where a patient walks into a clinic to meet a physician, for a general visit (known as 'office visit' in the United States of America) there is a procedure that goes along his visit, which is detailed below:
Every individual in the United States of America with a medical insurance has a medical insurance number which would be a part of the patient demographics, (a patient intending to meet a physician need to get an authorization from the insurance company and the insurance company in return would authorize the time slot and the reason for the patient to meet the physician.)
When the patient walks into the clinic for a checkup he would be billed to the insurance company, be it his primary or secondary or the tertiary insurance coverage. The procedure codes and the amount applicable for each procedure code is prefixed by the insurance company, the remaining is either taken as co-pay or if the patient has a secondary insurance coverage they would take up the remaining charges of the patient.
