HOW TO MAKE A HEALTH INSURANCE CLAIM?

It is important for every individual to purchase a health insurance plan so that one can conveniently obtain the best treatment and save on the expenses. In the case of a health insurance plan, the policy will help you cut down on the expenses of hospitalization and treatments. The policy will ensure that you obtain the best treatment at a cost that is affordable to you. To seek a reimbursement of the medical expenses incurred, it is essential to file a health insurance claim. One can only obtain the benefits after filing the health insurance claim in a form.

There are two ways to make a health insurance claim to modern private medical insurance companies

1.Through the Medical ServicesProvider (TPA): This is the easiest method to file a claim. The medical serviceprovider can submit the claim on your behalf to the insurance company. If thedoctor is in the network of insurers, they will automatically file a claim foryou. 

2. Filing the Claim Yourself: If yourmedical service provider is unable to file a claim for you, then you cancomplete the paperwork yourself. In case the medical professional is out of theplan, you will be required to file the claim.

Procedure tofile a claim:

1.Submit the Claim Online: Insurancecompanies offer the facility to log in to your account through the website ofthe company and access personal details.

•You will have to consult the insuranceprovider if there is no facility for online submission of the claim.

•Once you log in on the website,you will be able to find the form of the claim. Fill in the information andmail the supplementary documents to complete the process.

•The advantage of filing a claimonline is the accessibility to see the progress of the claim.

•The process is also much faster,and you can gain a quick response to your application.

2.Submit the Claim by Mail: If theinsurance company does not provide online filing services, you should send theapplication by mail. In this case, you can print the form, fill in the detailsand mail it with the necessary documents.

If you haveto file the claim by yourself, do not delay the process. Many plans have ashort duration for filing the claim and require you to file it within a periodof thirty days from discharge.

 To file a claim, you will berequired to obtain the receipts from your doctor.

• The itemized bill will be issuedby the doctor, which will include every service provided to you and the chargesfor the same.

• It is important to attach anoriginal itemized bill with the claim form.

• The claim form includes detailslike:

a.Your policy number or plan number

b.Who received the services

c.What was the service for

d.Co-Insurance or Co-Pay

• The form also aims to provideadditional instructions that will help you fill in the necessary details.

• Before the submission of theclaim, it is important to submit the bank details.

• All the documents collected at thehospital also need to be submitted with the form.

3.Make copies: Before you send theclaim form through the mail, it is very important to make copies of the same.It will help you keep a record and eliminate errors.

Keep yourinsurance documents safe and secure so that you can provide any additionalinformation if needed by the company. If there is any difference in the amountclaimed and the amount you are eligible for, the company will contact you toclarify the same. Complete documentation and original receipts help in thequick process of yourclaim. Obtain an itemized bill for a complete and quickclaim reimbursement procedure.

References:

https://www.bankbazaar.com/insurance/national-health-insurance/claims-procedure.html

http://www.patientnavigator.com/insurance-filing-a-claim-step-by-step/


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