claim allowance

Claim allowance is the process by which a healthcare insurer approves and agrees to pay for specific medical services or treatments you're entitled to receive under your health plan. When a claim is submitted, the insurer reviews it to verify it meets the policy's coverage criteria. If approved, they allocate a certain amount toward your expenses, reducing what you might owe out-of-pocket. Essentially, claim allowance confirms that your insurance recognizes and covers the service, guiding how much of the cost will be reimbursed or paid directly to the provider.