Health Insurance Claim Articles

Post-Treatment Follow Up With Health Insurance Companies

So, I have written about the importance of seeking your health insurance company’s pre-authorization / pre-certification of a medical procedure that you will subsequently be claiming with your carrier. But what about following up with your health insurance company after you have received medical services and sought coverage for same? Is it a good idea to stay on top of your health insurance company in the wake of medical treatment and claim submission? Absolutely, in my opinion.

Following the recent birth of my daughter, it became even more apparent to me just how important it is to religiously follow up with your insurance company in the wake of claim submission to ensure that the carrier is processing the claim appropriately. Had I not called a few times a week to check in on my carrier’s processing of my daughter’s claims, hundreds of thousands of dollars of medical benefits were bound for denial and I would have had medical providers banging on my door to collect. Thankfully, my phone calls with my insurance company resolved the carrier’s clerical confusion early enough to avoid medical providers banging on my door for payment of their bills.

Generally speaking, insurance companies have little to lose with taking a crack at claim denial on the first go-round. If you do not contest the denial (which, statistically, a lot of people do not), the insurance company profits. If you do contest the denial, well, the insurance company still makes out well via interest that accrues on withheld benefits. So, unless you are keen on holding medical providers (and associated collections agencies) at bay while you try to unwind an insurance company’s denial, try to nip things in the bud by inquiring of your carrier early and often along the following lines: “Hi Acme Ins. Co, it’s your policyholder, Jane Doe… how is the processing of XYZ claims coming along? Is there anything I can do to help you expedite the processing of XYZ claims or make the processing of such claims easier on you?” If these questions are met with confusion and / or resistance (as opposed to understanding and / or cooperation), it would behoove you to have a chat with a policyholder attorney if you had not done so already.

Health Insurance Claim Articles