Final answer:
A formal request for payment from an insurance company for services provided is called a Claim. Providers submit this to get reimbursed for medical services, which is then processed by the insurance and followed up with an Explanation of Benefits.
Step-by-step explanation:
The formal request for payment from an insurance company for services provided is known as a Claim. When a healthcare provider services a patient, they submit a claim to the patient's insurance company to request payment for the medical services rendered. The insurance company processes the claim and issues an Explanation of Benefits (EOB), which details what has been paid and what may be the patient's responsibility. An Authorization sometimes referred to as pre-authorization or prior approval, is a decision by the insurance company that a healthcare service, treatment plan, prescription drug, or durable medical equipment is medically necessary. It is different from a claim, which is the actual submission of billing for services provided. Lastly, a Pre-approval is similar to authorization but often refers to the agreement in principle for the coverage of a specific medical procedure or service before it takes place. Therefore, the correct answer to the student's question is A) Claim.