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TIPS ON FILING A HEALTH INSURANCE
CLAIM
SUBMITTING CLAIMS
CLAIMS – GO DIRECTLY TO INSURER’S “CLAIMS
DEPARTMENT”
SPEEDING UP THE CLAIMS PROCESS
KEY TO SHORT-TERM HEALTH INSURANCE
CLAIMS.
PAYING CLAIMS – HOW LONG SHOULD IT TAKE?
WHEN YOUR INSURANCE WON’T PAY
HOW COMPANIES DETERMINE “USUAL,
REASONABLE &
CUSTOMARY”
WHEN YOUR TRAVEL INSURANCE IS YOUR “PRIMARY COVERAGE”
INSURANCE
CLAIMS
CLAIMS REIMBURSEMENT--WHY IS IT SUCH A PAIN?
CLAIMS
SUBMITTED LATE CAN BE DECLINED
WHEN YOUR INSURANCE WON’T PAY
Parade, a Sunday news magazine (9.19.2004) includes an article suggesting
what we should do when our insurance won’t pay. There is not space to quote
the whole article, but here are the key points: (1) Don’t get angry – but do
get involved. Getting angry with service personnel is counter productive.
Sometimes denials of coverage are no more than a business decision made by a
computer. (2) Hold on to your written records. (3) Talk to your doctor – See
if you have been denied coverage for a drug, etc., that the doctor thinks is
absolutely essential for your well being. (4) Realize that most plans base
coverage on “medically necessary.” This means that you are not entitled to
the newest high-tech treatments, especially if they have not been fully
tested. (5) Do some research. The more you know about the medical treatment
the doctor prescribed the easier it will be to talk with insurance
personnel. (6) Call your insurance company and say, “I am appealing my
denied care.” Then put it in writing. According to law, insurance companies
need to respond in a timely manner to written appeals concerning care. It is
best to send your appeal by certified or registered mail. (7) If you think a
treatment or medication is urgent or required, get it. (8) If the insurance
company fails to cooperate with you, then contact your state government’s
Department of Insurance. All insurance companies are monitored in the USA by
the Department of Insurance and must be approved by this Department to sell
insurance in your state.
| Need Help? Call 480/813-9100; Fax 480/813-9930; Email: info@gninsurance.com |
