How to Read a Health Insurance Claims Loss Statement

Health insurance companies are in the business of making money. Often claims are denied in the hope of you not challenging the ruling. Persistency may seem cumbersome, but it is your responsibility to make your health insurance company pay for what it is supposed to. Insurance companies can be worn down the same way you can. Remember, an insurance company is run by people just like you. Read on to learn more.

Difficulty: Moderate

Instructions

1. Read and understand what exactly your policy covers and does not cover.

2. Learn the codes that your insurance company uses when they bill you. Insurance people speak in code—learn their language.

3. Telephone your customer service representative and go over your claims loss statement line by line. Make notes that will help you to understand how to read the statement later and without assistance.

4. Obtain a record of your medical visits and compare them to your claims loss statement. Make sure you are being denied for an appropriate reason.

5. Judge the loss statement objectively. Read each line to check for the accuracy of your personal information, accuracy of the claim statement and inability to work statement.

6. File an appeal if you feel your claim was denied—it is your right—use it.

Tips & Warnings

• You always have the option of writing an appeal.
• Don't be afraid to ask for a supervisor when calling customer service.
• Know and protect your rights.

Resources

• Example of a claims statement.
• Claims processing and solutions website.

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[leokeretlinter]

on 11/15/2009 Great article 5 stars

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http://www.MyOnlineInsurance.info