Tuesday, June 11, 2013

Dispute A Health Insurance Claim

If you have health insurance, it is imperative that you review any paperwork related to your health insurance claims. In most instances, you won't find any problems. However, in some cases, you may find that your doctor, hospital or laboratory made a claim to your health insurance company in error. If you have found such an error, you will need to take the initiative and dispute the claim.


Instructions


1. Review any paperwork related to the health insurance claim. You may have a receipt or list of services from your doctor. If you used the services of a hospital or laboratory, you may have a list of services from them as well. See if the claimed item that you intend to dispute appears anywhere on your paperwork.


2. Contact your doctor, the hospital or the laboratory to explain that you feel that they made a claim to your insurance company in error. Talk with the billing department or health insurance coordinator if you can.


3. Ask the billing department or health insurance coordinator for copies of their paperwork that relate to your specific case. Attempt to get paperwork that contains the appropriate diagnosis codes and medical codes, as these will be useful to your insurance company. Request that you get these copies either via fax or via mail. Look over this paperwork to make sure that you have a valid claim.








4. Call your insurance company to explain your case. Provide them with any of the paperwork that you have. Some insurance companies will also want you to send them a letter with your signature. Ask for a timeline in regards to your dispute.


5. Wait for a ruling on your dispute from your health insurance company. If you haven't heard anything from them by the date they promised, contact the insurance company again to check on the status of your dispute. If your insurance company requires any additional information or materials from you as they review your dispute, provide those materials as quickly as possible.

Tags: insurance company, health insurance, your dispute, your insurance, your insurance company, health insurance, hospital laboratory