6 Secrets to Getting Your Health Insurance Claims Paid FAST

Written by Mike

When you’re shopping for health insurance, your monthly premium amount is important, but it’s equally important to know that your insurance company will be just as interested in paying your claims in a timely fashion as they are in collecting your monthly premiums.  This handy checklist will make sure you’re just as happy with the service you receive after the sale as you are with the premium you ultimately pay.

  1. Let Your Insurance Company Know About Other Coverage
    You may think it’s nobody else’s business but yours, but it’s imperative that you let your health insurance company know about any other coverage you may have.  For instance, if your spouse takes a job to help pay bills – and that employer provides health insurance benefits – you could effectively wind up with double coverage.  While there’s nothing wrong with this because your benefits will coordinate, and you will wind up with no more than 100% coverage, you could potentially encounter problems when you file a claim if both companies don’t know about the other.  Many insurance companies will routinely deny ALL claims unless they are notified at least once per year of other health insurance you have in force.  Being proactive and keeping your health insurance company in the knowledge loop can prevent unnecessary delays and will get your health insurance claims paid more quickly.

  3. Pay Your Premiums on Time
    A no-brainer to most people, lapses in coverage due to unpaid premiums are one of the main reasons that legitimate claims are denied.  Some people are more comfortable paying their premiums on a quarterly, semi-annual, or annual basis in order to save money.  Because of the reduced frequency in which they make premium payments, it’s easier for these expenses to slip through the cracks.  Set up a payment reminder in your computer’s calendar, write yourself a note, and immediately open all correspondence from your insurance company.  If you don’t, you could very well miss an important premium notice or lapse pending notice, which will result in the denial of your claim – and the potential loss of important coverage (especially if you are diagnosed with some dreaded disease while you’re without coverage).

  5. Understand the Fine Print
    Nobody enjoys reading the fine print of their insurance policy, but by taking the time to educate yourself about what services your policy covers – and what it excludes – you’ll know right away whether something could be wrong if you get a denial letter in the mail.  Mistakes do happen from time to time.  When they happen, they can be corrected, but you do have to let your insurance company know about them right away.

  7. Save All Paperwork From Providers
    Provider paperwork doesn’t make the most interesting reading material, but by carefully examining paperwork that comes in the mail you can get an early heads-up to a potential problem with your pending claim.  For instance, if your claim is related to a home improvement project gone awry and your detailed hospital billing shows a charge for normal childbirth – and you’re a man – your insurance company will deny the claim.  By notifying your health care provider right away, you’ll be saving them valuable time while giving them a chance to get the claim corrected more quickly so it can be paid.

  9. Keep – and Review – All Bills
    You may not have an interest in how much the total bill was for your health insurance claim, but by reviewing the bill you may notice a mistake that could delay your claim being paid in a timely fashion.  In some cases you have an additional incentive in reviewing these bills: If you catch a billing mistake, some insurance companies will share their savings with you.  It’s so easy for a mistake to occur – and double-billing can also take place – that having an extra set of eyes can be an invaluable resource.  Don’t think of it as doing someone else’s job for them: Consider what you are doing as taking an active role in your healthcare and in helping to see to it that you get all of the benefits to which you are entitled – without delay.

  11. Respond to Insurance Company Inquiries Quickly
    If you get a letter from your insurance company requesting more information related to your claim, give it to them.  This happens if they don’t have enough information with which to decide if your claim is covered or not.  For instance, if your claim related to a trip to the emergency room for an injury doesn’t adequately explain the circumstances of your injury, the claim could be delayed – or denied.  The reason for this is simple: If your injury occurred while playing in a pick-up basketball game, it will be covered.  However, if you were at work and got hurt, the insurance company will more than likely deny your claim because it should be covered by Worker’s Compensation.  By responding quickly, you can clear up any lingering questions related to your claim which will allow the insurance company to pay your claim.

The secret to getting claims paid quickly is information.  When your insurance company has the right information at their fingertips they can process your claim and get it paid more quickly.  The wheels on the claims wagon will turn more quickly if you’re willing to take an active role in providing the information your insurance company needs in order to process your claim.

Now that you know HOW to get your claims paid quickly, it’s time to learn more about which company is best-suited to provide the coverage you need .