How To File a Health Insurance Claim: What To Expect

In some situations a medical bill will be submitted to your health insurance company that will be rejected by them and you will have to file a claim. This rarely happens but when it does many people panic because the cost to you can seem very high. The best way to handle this is to file a claim.

All insurance companies have a way that they ask you to submit a claim and they tell you when to do it. You must read this information and then create your claim using the appropriate claim form.

Here are some tips to help you file your claim correctly the first time:

Ask for an itemized bill -- your doctor's office will have a copy of every service that you have received and it will have the cost of each service. You are always asked to provide this information with your claim and this helps the representative who will see your claim to know the exact costs that you are asking them to reconsider.

Choose the right claim form -- call your insurance company and ask them to send a claim form. This is important because they form will tell you the information they need in order to process your claim. It is important to give them as many details as they request and if you have questions while filling out the form, it is better to ask them.

Make copies of everything -- never send in a claim form without making a copy of it and any documentation you send with it. There is nothing more frustrating then to get a call from the claims representative asking questions that you can't answer because you didn't save a copy of the forms.

Check it twice before you send it -- When you are in the middle of filing a claim you can make errors that you didn't mean to make. Before you send it in make sure that you check everything and make sure you filled in all the information. Also, check the form to see where you need to send it.

Be sure to file within the timeline -- most insurance companies have a certain amount of time within which your claim must be filed. Check with the company to see how long you have and make sure you get the claim in within the timeline.

What to do next

Once you have filed your claim it is a good idea to monitor what happens throughout the process. Find out how long it takes and then call them periodically if you don't hear form them. When they review the claim they will decide whether they pay it or reject it again.

If your claim is rejected a second time there is a higher authority that you can submit your claim too. Each state has a department of insurance that works with consumer concerns and they have their own processes for regulation. Often a call to this state insurance department can help you resolve the problem.

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