| Health insurance is no different to most other types | | | | appointment, so there's nothing else for you to do |
| of insurance - having the policy is one thing, but what | | | | until you receive the paperwork back from your |
| happens if you need to file a claim? There's no one | | | | insurance company. This paperwork will show you |
| answer to this question. That's because just about | | | | what percentage the insurance company paid, what |
| every type of health insurance plan has its own | | | | amount was applied to the deductible, and if there is |
| method for dealing with claims. Stop for a minute and | | | | any balance due to be paid by you. |
| think about how many health insurance companies | | | | Indemnity Plans used to be quite difficult to deal with |
| there are, then multiply that by the number of | | | | when it came to filing a claim. Usually you had to pay |
| policies each company offers, and you start to realize | | | | for the medical service up front, and then you'd fill |
| why giving advice on how to file a claim can be so | | | | out a lengthy claim form and send it to your health |
| difficult. | | | | insurance company. You would then have to wait |
| This may sound obvious, but if you're not sure how | | | | anything up to a couple of weeks to receive a |
| to go about filing a health insurance claim, and even if | | | | reimbursement. Nowadays, it's more common for the |
| you're not sure whether it's covered by your policy, | | | | front office staff to directly bill the insurance |
| the best thing to do is ring your health insurance | | | | company for the medical service you received. Then, |
| company. If you look at their paperwork or website, | | | | once they find out what percentage of the bill will be |
| they will usually have a toll-free number that's staffed | | | | paid by the insurance company, they will bill the |
| during business hours to assist customers. Some | | | | remainder directly to you. If there's a dispute then |
| bigger companies may even offer extended contact | | | | the medical services provider will bill you directly, and |
| hours. You'll need to have information about your | | | | you are obliged to pay. It's then up to you to |
| policy on hand, including the policy or group number, | | | | contact your health insurance company and sort it |
| and the name of primary person insurance by the | | | | out. |
| policy. Once you've provided those details, the | | | | Now that computerization is so advanced, the |
| customer service person can look your policy up on | | | | medical billing process is much more streamlined, and |
| their computer and give you specific advice about | | | | generally as a patient your only cost upfront is your |
| how to proceed with your claim. | | | | co-payment. Even if you need to pay the deductible |
| Filing a claim for a covered benefit under a Managed | | | | first, the paperwork goes to the insurance company |
| Care Plan is usually quite simple. Quite often the front | | | | to determine the correct amounts, so there's a delay |
| office staff at the medical facility you visit will take | | | | before you need to pay. This also means the health |
| care of the necessary paperwork for you, so you | | | | insurance company can keep your policy usage and |
| won't need to file a claim. They know all the proper | | | | payment history up to date. Considering the sheer |
| medical codes that apply to the service rendered, | | | | volume of paperwork these companies deal with |
| and will forward the correct paperwork to your | | | | every day, most claims still get settled reasonably |
| health insurance company. If there's a co-payment | | | | quickly. |
| required, you pay that at the time of your | | | | |