How to Get Medical Claims Approved by Your Insurance Company

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Getting medical claims approved by your insurance company is sometimes easier said than done. Find out how to get medical claims approved by your insurance company with help from the president of The Stratford Financial Group, Inc. in this free video clip.

Part of the Video Series: Health Insurance & More
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Video Transcript

Hello, I'm Jeffrey Ingalls; President of Stratford Financial Group and Stratford Employer Services in Wayne, New Jersey. And right now, we're going to discuss how to get medical claims approved by your insurance company. Information is power especially when it comes to getting medical claims approved by your insurance company, especially the ones they may have denied or the ones they may not be contractually obligated to pay. You need to be prepared before the problem arises. First, you need to understand your benefits. You need to keep your benefits booklet, certificate booklet and all other plan documents stored as reference for if and when you may need them. Second, secondly, when speaking with your insurance company, you should document each phone call. If you send an email, that's even better 'cause you will get an email documented response. But, if the conversations do take place over the phone, you should document each phone call. Generally speaking, insurance company representatives at the conclusion of the call will issue you a confirmation or service request number which documents the subject matter that was discussed. If you find yourself in a situation where your insurance company is denying a claim, you feel that they should pay, you should take the following steps. First, make an inquiry to their claims department and explain the situation. If you receive an adequate response, you can stop there. If not, I would file an appeal or a grievance with your insurance carrier. On each of your explanation of benefits, they should describe the steps you should take to enable you to do so. Thirdly, I would consult with your broker or consultant and see if they can be of assistance in rectifying the claim issue. Lastly, you can always file a complaint with your states's Department of Insurance and then try to obtain a preferable result in that fashion. My name is Jeffrey Ingalls. I'm the President of Stratford Financial Group and Stratford Employer Services in Wayne, New Jersey. We can be found online at www.stratfordlink.com and you just watched how to get medical claims approved by your insurance company. Thank you.

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