Final answer:
Insurers need to know hospitalization details and insurance policy specifics such as deductibles and coverage limits to process hospital indemnity claims, while also adhering to patient confidentiality requirements.
Step-by-step explanation:
To process most hospital indemnity claims, an insurer needs to know two basic pieces of information: first, the details of the hospitalization such as the dates of hospital stay and the medical services provided, and second, the details of the insurance policy including the coverage specifics like the deductible, co-insurance, and maximum coverage limits. The policy details help the insurer determine how much is covered under the policy and what portion of the costs the policyholder is responsible for paying.
In addition, due to the Health Insurance Portability and Accountability Act (HIPAA), insurers are required to maintain strict confidentiality of patient records. They must balance the need for this information with legal and privacy considerations that protect the patient's sensitive health data.