|
Health Insurance
Health Insurance Claim Process
You will encounter a situation wherein you will have to make a claim against your insurance policy. How does the claim process go? Well, this depends on a lot of factors.
Your health insurance policy claim process will be based on the kind of policy you have taken up, your insurance company’s handling of a particular policy and also the laws applicable to your state. Every insurance company offers different types of health insurance policies and each has its own characteristics and they are not the same as health insurance policies offered elsewhere in the same state or in different states. Given this situation how do you begin to understand the claim process?
You can find out about how to make a claim from the insurance company itself. They will have a toll free number that you can call up for such enquiries. Keep with you the policy number as you will be asked for this. You will be required to give details on your policy so have all the details ready with you such as the date you took the policy, the type of policy and so on.
In the case of managed health care plans, staff at the medical care facility you visit will do the necessary paperwork for you. If you have opted for an indemnity plan you would have to pay the medical provider and then make a claim on your policy for which you will have to fill out your claim details in claim forms and sign it up before sending it to the insurance company for reimbursement. These days the medical care provider sends the bill to the insurance company instead of the patient, looks into what is received from the insurance company and if required, goes ahead to bill the patient. In a fee for service plan, either you or your medical provider will file a claim against a visit and the medical provider will receive a fee for services rendered.
Though the claim process of a policy depends on many factors, the general steps you need to take when filing is to collect together all the receipts from your medical car provider on all your visits, and use them to fill out the claims form which you get from the insurance company. Make copies of the receipts and the claims form. Call up the insurance company to inform them that you will be sending in a form and review the paperwork you have with you with a staff to ensure you have done all that is required. Ask them when you can expect reimbursement and mark this date. Finally send the claim from to the right postal address.
Today with automation, filing a health insurance claim is not complicated as it used to be, because there is an efficient system that tracks down everything. If disputes arise between you and your insurance company on claims, you will have to sit down with your medical care provider to sort this out. If you are still not satisfied, you can take up legal advice to resolve the matter.
|
