Steps To Filing Health Insurance Claim

​Sickness and illness are inevitable and require medical attention. The last issue you may consider is submitting an insurance settlement. Purchasing a healthcare plan is critical to ensure a person's financial stability in case of illness. 

If the policyholder receives reimbursement, they will seek treatment at a non-network clinic and settle the medical expenses independently.   Following approval, the insurance company pays back these bills.

Understanding Medical Claim
When the hospital bill is already available, that is the time that you may process a medical claim. It is a billing request sent by your health provider to your healthcare insurance provider. The request includes all the services and medications you received. 

The health claim should ensure that the doctor is paid, you are paid for the remaining amount, and your insurance plan covers your health benefits. A request is initiated the moment you arrive for a doctor's appointment. The claim counts from the first day you receive medical services until you pay your final medical bill. 

Kinds Of Claims
There are mainly two kinds of settlement when it comes to medical reimbursement.

1. Claims Without Cash
   If you choose this type of claim, you will not have to pay for the expenses out of your pocket. Your insurer would deal directly with the hospital and cover the costs. There are two requirements for the same.
   
   First, your health insurance policy must cover your or a family member's illness. Then, the hospital you wish to visit should be on your insurer's list of network hospitals. You can file a cashless claim if the first two conditions are met and the hospitalization is scheduled.
   
   
2. Claims For Reimbursement
   A repayment claim is the inverse of a cashless request. You may file a reimbursement request if you do not choose the cashless option or are hospitalized in a non-network medical center.
   
   You can proceed with your regular hospitalization and payment procedures. When you are discharged, contact your insurance company as soon as possible and file a claim together with all pertinent hospital papers. The insurance provider may deposit the accepted sum into your account.

How To File A Healthcare Insurance Claim
The policyholder should send medical bills and all related documents to the insurance provider to reimburse medical costs. Insurance carriers should carefully read the policy's terms of the agreement. Follow the simple steps outlined below:

1. Prepare Hospital Bills In The Order In Which They Occur.
   It is the first step in the reimbursement process for medical insurance. Request an expense report from your healthcare provider. It should include information such as:
      - Surgery
      - Medical Expenses
      - Laboratory Reports
      - X-Ray Results
      - Summary of Discharge
      - Invoices for Consultation Fees
      - Take-Home Medications
      - Cardiovascular Examinations
   
   Ensure that the expenses submitted include the tax invoice number, date of an invoice, patient's name, and doctor's name. The total costs with GST and the signature of the appropriate personnel are also required. 
   
   
2. Obtain Claim Form
   To acquire a healthcare insurance claim form, immediately notify your insurance provider or print a form from their website. Your claim form will also include instructions on what additional information they may require from your doctor or healthcare facility. It is best to read it before starting.
   
   
3. Copy Everything
   Once you've completed your claim form and received your doctor's itemized bills, it will eliminate any claims process errors and make it easier to re-file your health insurance claim if it is lost. Check the billing codes for medical errors, and contact your health provider if you have questions. This step will keep your health insurance from being denied due to incorrect information.

Conclusion
The health care company may evaluate the case and the documents submitted. Once approved, the provider may reimburse the expenses to the insured's bank account. The repayment period ranges between seven and fourteen days. If the documents are incomplete or rejected, the insurance company will notify the claimant.

At Choice Enrollment, we do our best in making sure that our clients are well-protected with affordable and comprehensive policies. We make sure to go the extra mile to help you with your needs. To learn more about how we can help you, please contact our agency at (719) 481-1616 or Click Here to request a free quote. Any coverage discussed is not guaranteed. Please contact us today to go over your policy to ensure your needs are met! We are here and happy to help.