What classification do insurance companies fall under when they manage Medicare claims?

Insurance companies that manage Medicare claims are referred to as fiscal intermediaries. These entities play a crucial role in processing Medicare claims, ensuring that claims are handled accurately and in compliance with federal regulations. Fiscal intermediaries can include private insurance companies that contract with the government to administer Medicare Part A claims, such as those for inpatient hospital services. They are responsible for receiving claims, determining coverage, and making payments on behalf of the federal government.

This classification emphasizes the role of these intermediaries in the Medicare system, distinguishing them from other entities like third-party payers, which generally refers to any organization that pays for healthcare services on behalf of the insured, or central administrators, who would not typically have the direct involvement in claims processing. Network providers relate more to healthcare providers who have agreements with insurance companies but do not directly manage claims. Thus, identifying fiscal intermediaries is essential for understanding the infrastructure of the healthcare reimbursement process within Medicare.