Magazine article The Exceptional Parent

Managing Your Medical Bills & Insurance Paperwork: Tips for Maximizing Reimbursement

Magazine article The Exceptional Parent

Managing Your Medical Bills & Insurance Paperwork: Tips for Maximizing Reimbursement

Article excerpt

Do you become frustrated and overwhelmed when managing your medical bills and filing your health insurance claims? You're not alone. It can be extremely difficult for the average patient or caregiver to get through the "maze of insurance land." For people with a chronic or terminal illness, or acute episodes of illness as well, managing and filing insurance claims can be a particularly complex, frustrating, stressful, confusing and time-consuming process. But, given the high cost of healthcare today, it is critical that claims be filed and managed correctly to ensure you receive all the payments due to you, to make certain that you pay only the bills you're supposed to pay.

There are several ways to minimize the difficulty that surrounds the process of medical bill management and claims filing. Carefully following the suggestions here can be of significant assistance.

To protect yourself and to help maximize reimbursement, you might want to use a professional medical bill management and claims filing service. If you do file and manage your medical bills on your own, you can learn to avoid many of the mistakes that are so easy to make. Even if your provider files your claims, you need to be in control in managing the process regarding reimbursement and paying bills.

Here are some helpful hints to get you through the red tape, lower the stress level and, hopefully, put more money back in your pocket.

1. Whenever possible, try to have the doctor's office file your claims and even accept assignment.

If your doctor accepts assignment, it means that he agrees to file the claim and to accept, as payment in full, the amount the insurance company approves. Your doctor cannot balance bill you for the difference between his charge and the approved amount. In most cases, the insurance company will pay the provider directly when he participates with the insurance program. If the provider accepts assignment or participates with your insurance program, your only obligation usually is the co-payment, as stated in the policy. Many providers will ask for this co-pay at the time of your visit. Try to have them bill you for the co-pay after they have filed the claim and been paid by the insurance company. Many people pay the wrong co-pay. For example, they pay 20% of the charged amount instead of 20% of the approved amount, and consequently overpay and never get back a refund.

2. If you have more than one insurance policy, do not assume that the provider will file the claim.

If you have to file the claim, be certain to give the insurance company all the information it needs. Incorrect or missing information will only cause a delay in processing the claim. If you need to submit an itemized statement, be certain the following information is included:

* Diagnosis

* Description of service

* Charge for each service

* Date of each service

* Location of each service

* Name of the provider (doctor, hospital) who actually treated you

* All appropriate insurance numbers

3. File your claims as soon as possible.

Don't let the bills or receipts pile up--and, certainly, don't save all your claims until the end of the year. Many people think it's easier to file their claims one at a time.

4. Don't pay any bill unless it is clearly understood that it is a final accounting and you are responsible for it. …

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