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Don’t Sweat Over Health Insurance Claims – Follow These Tips to Get Your Claims in Action!

A health insurance claim is a request for either direct payment or a reimbursement for some medical services you avail. To obtain any funds or benefits from your health insurance, you have to submit a health insurance claim. This submission is made in the form of a request. There are two ways to do this.

Your Filing Options

The first method of filing a health insurance claim is the easiest and most convenient of the two ways. This is when you submit your application directly to your health insurance company through your medical service provider using an online platform. All they have to do is enter your insurance ID, the treatments you avail, and the bill amount. The hospital will directly receive the payment if your claim is approved.

The second way is a little more time consuming and requires you to fill a  health insurance claim form. Your insurance provider will send you this form. This is done when your hospital is not part of your insurance provider’s network hospitals. As your hospital will not be able to make an electronic claim submission, you will have to do it manually.

Submitting Health Insurance Claims Online

During the earlier days, you had to send your insurance claim by post. However, now you can do it all online through the health insurance provider’s website. Technological advancement ensures that you can submit your applications in multiple ways. Thus making it easy for the service provider, hospital, and the patient to make the most of the facilities and with ease.

Submitting claims forms online also means that it will be done faster. That’s because there’s no paperwork and lesser scope for human error.

The Info You Need to File a Claim

So, let’s say your doctor or medical facility doesn’t ask for your health insurance to process the bill. This means you have to do this on your own. There are a couple of steps to follow while filing your claim. Your medical bill being the first document, you will also need your policy number, member number, or the group plan number. An error in any of this information could mean an insurance claim rejection. So, be careful while you file.

Besides this, you should also be able to provide information as to whether the medical services or attention was given to the principal insured member or a dependant. This includes the insured person’s spouse, child, parents, or domestic partner. These apart, you should also provide information if there’s dual insurance or co-insurance, the reason for your visit to the medical facility, etc.

The Steps to Take When Submitting a Claim

Firstly, you have to ask your medical facility or the doctor for an itemized bill. This type of bill has the details of all the services you availed during the consultation. It also provides the costs of each item on the list. Ensure that the list includes information on the costs of medication as well as the details of the treatment you underwent. Your health insurance provider will need the original itemized bill, so you should attach it to your claim form. Next, contact your insurance company and obtain a claim form. You may also check if they provide it online on their website.

The claim form usually has additional instructions on the information that your insurer will need. Ensure that the codes on the bill are correct to avoid claim rejection. Make copies of the bill after filling in the claims form and attach the original bill to the form for submission. The photocopies can come handy if there’s a claim rejection, and you have to refile the application. Review the entire claim and what you have filled to ensure that everything is correct. Call your insurer and inform them that you are going to apply for a claim. Ask them if there is anything else you require. Submit your claim.

Submitting health insurance claims isn’t anything to be nervous about, and there isn’t anything they ask for that is difficult to obtain. The faster you claim, the better for you, because some companies have a timeframe within which your claims should be submitted. In most cases, an error in the form is what leads to rejection. So, be careful while you file!

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