INSURANCE: Be Proactive With Your Insurance Company: They Work For You

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Seeing the doctor to deal with health issues can be difficult enough, but many people find the real headache comes from trying to deal with insurance companies. Yes, this can be a stressful experience, but if you are prepared you will find it is much easier.

First Steps When Faced With An Insurance Issue

Remember that nobody is perfect. Issues arise out of confusion not out of conflict. Sometimes there is miscommunication and sometime it is just misinterpretation of information. The latter is actually pretty common when dealing with insurance companies because the lingo and the structures of their schedules can be complex. This is even more common today because of the constant changes in regulation. Often the insurance company will deny claims initially in hopes that the patient will give up on pursing the insurance claim. As a provider, this has happened to me personally. I recommend and empower people to follow-up and question the decisions made by the insurance company. After all you are paying for the services that the insurance company is providing for you!

So the first thing you might want to do is make sure that you understand the source of the problem. Is it that you don’t understand some fine print in the policy? Is it that you can’t find someone to answer your questions? Are you having trouble with the benefits schedule?

Medical Claim Denied Stamp Showing Unsuccessful Medical Reimbursement

Cut to the Chase: Navigating the Chain of Command

This is actually an important strategy you will want to plan ahead of time. Navigating the chain of command is not always easy; just be sure that you are courteous and exact. Know what you are looking for and how to ask for it so that you can get directed to the right person. Keep all information that they will ask (policy number, personal identification information, etc) on hand because they will probably ask it every time you get transferred.

Best Practices In Documenting and Communicating

And while you have that information nearby, make sure you keep a pen and paper with you as you document who you talk to as you navigate the chain of command. This is how you keep the insurance company accountable for the information they provide and how well they perform their customer service. Ask precise questions and keep track of the answers. And if you are not receiving the information or there is confusion, do ask to speak to a supervisor.