Getting an insurance company to pay your medical bills can be done by submitting a health insurance claim. You may want to file for a health insurance claim to reimburse your expenses if you obtain any medical services or treatments. The most convenient way to file a health insurance claim is by having your medical provider submit the form directly to your insurance company electronically or through the network.
The only other option is filling the health insurance form on your own and sending the paperwork to your insurance provider. Fortunately, this process can be done online and all you have to do is obtain the necessary information to complete the claim form. Here, we will tell you everything you need to know in order to submit a health insurance claim and receive the benefits for your medical services.
The Information You Need for a Health Insurance Claim
To submit a health insurance claim, there are a few steps you need to take. The first step is gathering the needed information for filling out your claim form. In the form, you’ll need to provide your insurance policy number, your member number, or your group plan number. You’ll also be asked about the person receiving the services, for example, the policyholder or one of their dependents, such as the spouse, the child, or any domestic partner. Speaking of which, the form will ask you to state if you or the person receiving the service, have any dual coverage or coinsurance. Finally, you’ll be asked to mention the reason for the medical visit, for example, if it was due to an accident or if it’s a worker’s compensation case.
Obtain Itemized Medical Bills
The first thing you need to do after receiving medical services is to ask the doctor for itemized receipts of every service they have provided. An itemized bill will have records of all the charges and services received during medical care, and it should also include a list of all the medications, drugs, and treatments provided with their itemized costs. These receipts are important for your claim as your insurance company will ask for the original medical records and the costs to be attached to your claim form. Making copies of these documents is important to keep track of your paperwork, and it will be easier for you to fill the form again if the original copy was lost.
Obtain Your Insurance Claim Form
To get a health insurance claim form, you will need to contact your insurance company directly or go to their website and download it. Douglasville-based lawyers from Sherrod & Bernard suggest reading the form carefully as it may contain additional information or instructions needed by the insurance company from your doctor or the healthcare facility. After obtaining and filling out your form, attach the requested medical receipts and make a photocopy of these documents to eliminate potential errors in the claim process.
Read Your Policy Carefully
Your insurance company could make mistakes or misinterpret some of your policy coverages. If you notice that your policy can provide and cover more than what you’re receiving, make sure to talk to your insurance agent.
Sometimes, the settlements given by the insurance companies don’t sound fair and that’s because they are not. Also, if your health insurance claim is denied, the first thing you need to do is get in touch with your insurer for a detailed explanation of why they rejected your claim.
Talk to Your Insurance Agent or HR Department
The insurance agent that sold you the policy and the HR health benefits manager both owe a duty to ensure that your insurance coverage protects all of your interests. You should be able to contact either one of them in case you need help with a claim denial. They can help you understand the limitations of your policy and explain more details about the claim. They can also contact your insurer on your behalf to discuss your claim. If necessary, you can ask for your doctor’s support when it comes to building a strong case and going against a claim denial.
Obtaining medical care benefits is all about knowing the procedure and gathering the needed documents and paperwork. It starts with your medical visits where you have to keep a record of all the provided services in order to document everything, especially the costs. Then, as an insured individual, you need to complete the claim form and submit your medical bills for reimbursement. If your claim is denied, don’t hesitate to contact your HR department or the insurance agent that gave you your policy to know more about the limitations and benefits of your insurance coverage.