Health Insurance Articles

How To Get A Quick Turnaround On Health Insurance Claims

2010-02-09

Having the right health insurance coverage can be a lifesaver in times of need, but it can often take a great deal of time to get the proper payout on a claim. There are several ways in which a client can help to ensure that their claims are processed both quickly and accurately.

One of the most important steps in making sure a health insurance claim is turned around quickly is to use providers within the insurer's network. This means that they will be familiar with the health plan's form and billing practices, and will be far less likely to miss paperwork or submit charges which will not be covered. If a visit to an out-of-network provider is required, contact the insurance company beforehand and make sure to either have the proper paperwork sent to the service provider directly or take it there in person. While insurance forms are all similar, each company will have its own particular practices, and having the wrong form with the right information can slow down a claim or even have it fully rejected. If the out-of-network provider requires that the client submit the form themselves, be very sure to ask about all information contained on it. Send it registered mail to the insurance provider, and follow up with a phone call to make sure it is received. Missing paperwork will not typically result in a call to the client asking where it is until it is too late and the claim is significantly delayed.

For any major medical treatment or procedure, it is always worthwhile to speak with the health insurance provider directly, and to make sure all paperwork showing what has led up to this claim is in place. A missed form, even if the client is not responsible for it, can significantly slow down the speed at which a claim is processed. As well, see what kind of online or electronic options the insurance provider has for forms. Recent studies have indicated that 30-35% of all paper copy claims are rejected due to significant errors, either by doctors or clients. An electronic submission program can limit these errors to 1 or 2 percent. This lower error rate, combined with an electronic database of containing a client's history and submitted forms, can often shorten the payment turnaround time.

The keys to any quick turnaround on a health insurance claim are to be in contact with the insurance provider and make sure that all required documentation is submitted. Make sure to be very clear about what exactly is required and what form it needs to take. This will prevent continued callbacks and questions, allowing the payout to be processed in a timely manner.