IntroductionWe always say I'm healthy, but what does being healthy actually mean? The term healthy is defined differently by different people. In general, being healthy means being free from disease or any form of injury. But is it really true? Can anyone be truly free from any form of disease or injury? The answer to this question is no. People are susceptible to illness or injury, but after getting sick what? Then comes the supplier visit phase. The number of visits (to doctors' offices, hospital outpatient departments, and emergency departments) is 1.2 billion in the United States alone [1]. Furthermore, such visits are very expensive. The only factor that makes it affordable is health insuranceWhat is health insurance According to the Health Insurance Association of America, health insurance is defined as "Coverage that provides the payment of benefits as a result of illness or injury. It includes insurance for losses from accident, medical expenses, disability or accidental death and dismemberment" [2]. Health insurance processing is one of the few complex processes that occurs after visiting the provider. The compensation request is made after pre-authorization. Pre-authorization is an integral part of usage management. What is usage management? Utilization management (UM) is the process by which a health system, services and facilities can be evaluated to see if it is appropriate and if it is established according to the guidelines established by health care plans. Utilization management describes proactive procedures, discharge planning, concurrent planning, precertification, and clinical case appeals. UM also covers concurrent clinical review and appeals filed by the provider, payer, or patient. Usage m...... half of the document ...... the benefit submission (EOB) is created along with the benefit check which is mailed to the patient and doctor respectively. Conclusion Reference:[1] Selected Patient and Provider Characteristics for Ambulatory Care Visits in Doctor's Offices and Hospital Outpatient Clinics and Emergency Departments: United States, 2009-2010[2] How Private Insurance Works: A Primer by Gary Caxton, Institution for Health Care Research and Policy, Georgetown University, on behalf of the Henry J. Kaiser Family Foundation.[3] http://chiroeco.com/chiro-blog/medical-clearinghouse/2009/04/07/paper-claims-vs-electronic-claims/[4] http://www.ihealthbeat.org/picture-of-health /2013/what-percentage-of-health-insurance-claims-were-filed-by-paper-or-electronic-processes[5] http://www.wisegeek.org/what-is-claims-adjudication.htm [6] http://www.staysmartstayhealthy.com/health_insurance_deductibles