Top Six Tips For Ensuring Your Medical Claim Goes Through Fast
Nobody likes getting sick, but what’s even less fun than that, is having to deal with insurance companies. Medicare is no different in that regard. There are still forms to fill out and paperwork to file. When you’re already not feeling your best, that kind of stress can really get to you. Here are a few helpful tips to be sure that when you submit your claims, they’re handled quickly and efficiently, and you get reimbursed promptly.
Read the Fine Print
Your journey to fast, smooth claims processing begins before you even file, and it starts with an in-depth understanding of your policy and what it covers (and specifically does not cover). Only by understanding these details can you ensure a smooth, hassle free process.
Receipts – Save ’em If You’ve Got ’em
Never throw any receipt away for at least seven years. It’s a good rule of thumb, and let’s face it, if you haven’t been reimbursed in that time frame, you’re not going to be.
Be Sure to Follow All Filing Instructions
All insurance companies have processes and procedures, and the people handling the claim when it arrives at the processing department have a fairly strict set of protocols that they’re not allowed to deviate from. At all. That means that if anything is missing from your claim, if you forgot to submit a certain form, or attachment, or if you failed to sign something, your claim will be rejected and sent back. Be sure you’ve got your proverbial i’s dotted and t’s crossed.
Document, Document, Document!
Get copies of your medical records and send these with your claim, even if not strictly needed. Nobody ever got denied for sending too much information, but the opposite problem causes all manner of delays.
If you’re going to file, file as quickly as you can. Don’t sit on the claim for six months to a year. Not only do insurance companies have “timely filing” rules, but you’re not sending a very good message. If you can afford to wait three months before filing your claim initially, they’re not going to be overly inclined to rush on their end.
If Denied, Gather Intel
There are three magic pieces of information you need to get if your claim is denied despite all of the above. You need the ICD-9 code for the thing that was denied (that’s the “diagnosis code”), then the CPT Code (that’s the procedure code), and finally, the SPD (Summary Plan Document), which is a book that details every procedure and diagnosis code covered by your insurance. If your research with these three pieces of information reveals that the procedure and diagnosis codes are, in fact, covered, your appeal is going to be overwhelmingly likely to succeed. Insurers don’t quite know what to make of it when patients know that level of detail.
We are always there to help you with any problems and issues over insurance claims, so don’t hesitate to get in touch.