Do you know that the primary reason for health insurance claim denial is that the policyholder doesn't follow the necessary steps or doesn't provide the necessary documents? Yes. It's true. First of all, before visiting a doctor make sure that he's covered by your health insurance policy. Also, inquire whether or not medical tests such as, lab tests, x-rays, etc. are covered. It will help you know how much compensation you can claim from your insurer since the insurance company will not compensate the costs that are not included in your policy.
Here are 4 steps which you need to follow to make a health insurance claim.
1. Make the required co-payment: At first, you need to make the co-payment, as mentioned in your policy, for the health care services provided to you.
Though in most of the policies, the health care provider needs to file the insurance claim, yet in some policies, you, the policyholder, may need to file the insurance claim. In such a situation, you should follow these steps in order to get the required compensation.
2. Collect all the necessary documents: Make sure you keep all the necessary documents which you may require to file the health insurance claim. So, make sure you keep all the receipts if you need to make any upfront payment. Along with this, ask for an itemized bill for health care service providers in which all the fees, services and other costs are clearly mentioned.
3. Fill out the claim form: To file the claim, you need to obtain a claim form from your insurance company. Then, fill out the fields mentioned. You'll have to give out details regarding the reason you're filing the claim, basic questions about your insurance policy, etc. If required, get help from a professional if you're not sure what to write in any specific field. Always double check to ensure that you haven't left any necessary field empty.
4. File the insurance claim: After filling out the form, attach the necessary documents. It is better to make copies of the documents and the claim form you're mailing to the insurance company. This is because you'd be able to provide the copies of documents if your claim form gets lost or you need to produce as evidence, in future if required.
Do not forget to do follow ups, after a certain time frame. This is because the insurance companies receive a number of claims, so your one may get delayed. It is always better to call your insurer and ask about your claim. Remember, discussions with your insurer can often resolve certain disputes if your claim is denied or you don't receive the desired amount.