A claim is simply a request for
payment of services. Typically, your health care
provider will make the request but it is sometimes
the responsibility of the patient. This is one
of those questions that’s best asked before
you take out a health insurance policy.
Start by talking to your health insurance broker.
Ask if claims are normally submitted by the patient
or the health care provider. Next, talk to the
insurance person at your doctor’s office.
Be prepared with specifics - the name of the insurance
you’re considering, the type of policy,
and whether there’s a deductible
or co-payment. Ask whether
they are willing to submit claims on your behalf
and find out about their payment options while
claims are being processed. Most physicians and
pharmacies will accept whatever portion of the
bill you’re required to pay as payment in
full at the time services are rendered. But some
may require that you pay in full with the understanding
that your insurance will reimburse you. That’s
an important detail and one that could change
your mind about which policy to purchase.
Once your insurance policy is in place and you’ve
made a claim, you’ll likely get a notice
from your insurance provider.
Though it’s tempting just to drop it in
the trash - especially if you’ve had a series
of illnesses and have seen lots of those letters.
Avoid the temptation and look over the charges.
You are the first step in eliminating insurance
fraud and you are the only one who can spot bogus
charges at this level.
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