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Make Processing Health Insurance Claims Easier

There is nothing more frightening in the real world than getting a bill for a health service that you thought would be covered by your health insurance policy but isn’t. Different than your standard Certificate of Benefits (COB) a bill is an actual request for payment from a service that is either not covered under the details of your health insurance policy or will not be covered simply because you didn’t follow some procedure correctly. Luckily, there are many ways you can avoid facing this bill:

  1. Call your insurance company before you get treatment: If you aren’t sure that a certain procedure will be covered or that a specific doctor or health center is under your plan, call the health insurance company before you get treatment. Make sure you write down the date and time of your call as well as the name and employee number of the person you speak to.
  2. Read your policy: Sure it’s boring, but if you take the time to read your health insurance policy, you’ll find out a lot about what is and isn’t covered and the procedures you must follow to ensure proper claim payment.
  3. Find out when precertification is necessary. Some health insurance companies require precertification before you can get certain procedures done. During precertification, you supply your insurer with information about the procedure you need and a doctor’s note or records that explain why the procedure is necessary. Call your health insurance company to find out when a precertification needs to be done with your policy and make sure that you write down the procedure.
  4. Pay your policy on time: One of the biggest mistakes people make is to allow their policy to lapse by paying it late. You must always pay your premiums on time in order to ensure an active, benefit paying policy. Pay early as often as you can as a safe guard.

Remember, ask first and you should have no regrets later. Take the time to familiarize yourself with your policy and you may be able to avoid bills outside your copay and deductible forever.


July 15, 2010



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