Closure occurs after the claim is resolved, all payments issued, liens satisfied, releases obtained, and any reporting obligations completed. Reserves are released and the file is archived.
Claims may be reopened if new obligations arise, such as a lien not previously identified.
Alternative Names:
Closing a Claim, File Closure
Why it Matters?
Premature closure creates real problems, since a file closed before Medicare reporting, lien resolution, or a final release is documented can require reopening under less favorable circumstances. In workers' compensation, closure interacts with future medical obligations and set-aside requirements. Closure also stops the accrual of allocated expense, which is why the timing appears in carrier performance metrics.
Frequently Confused with
Related terms
Frequently asked questions
What must occur before a claim is closed?
Can a closed claim be reopened?
