How to Pick Private Health Insurance Plan
Don' think your work ends the moment you enroll into a health plan as you should be more aware about their own health care. They should be able to research treatments, securing pre-authorizations and should know what step to take if their private or group insurance policy claim is denied. Knowing all this important as no one wants to tolerate a denied claim in middle of facing a health crisis. Denial of claim at such a crucial period can leave your drained emotionally and financially. Good thing is most claim denials can be avoided by following few simple steps.
Like, contact your insurance provider, then ask them to let you talk to someone who specializes in the area of treatment you're receiving. Chances are that person might be the one reviewing you claim; you can ask this person what might/might not be covered in your policy. Don't forget to take and write down that person's number in case you need to ask some more questions in future. It'd be wise to make detailed notes on exactly what's happening, and retain all related paperwork, even if information seems irrelevant to you. Include following in your notes:
- Date of your treatment.
- When your treatment's pre-authorization was requested and received and from whom.
- All relevant points discussed with physician, what actions were taken/suggested and what follow-up is needed.
Few other things to do before you select a plan:
- Research, review and understand your state's laws on what should be covered in a claim and what it considers "arbitrary." Knowing this important as it will influence provider's definition of "medical necessity" and billable requirements.
- Don't forget to make sure that human resource department of your company is informed, if your cover is fully or partially paid by your employer company. It's done so they could help you with paperwork in unmanageable situations.
- Also, be sure your doctor and insurance provider is in contact with each other and all necessary paperwork has been forwarded by one from the other.