5 Ways to Prevent Denial of Health Insurance Claim

​Whether you’re planning to purchase a new health insurance policy or sticking to an old policy, you should learn how to make claims. Many insurers deny claims by mistake. This gives you, the patient, a big headache dealing with medical bills. Thus, you need to take some precautions in order to reduce cases of rejection by the insurer. Here are some of them.

Double-Check All Information
Never fail to review all the information at least three times before sending out the long forms for your claims. The good news is that websites will allow corrections while you communicate with your doctor. Patient portals are coming up in order to automate data input from policyholders who want to make claims. However, while things are not yet automatic, you need to be extra careful.

Ensure Correct Diagnostic or Procedure Code
Be careful with diagnostic codes and procedure codes. The payer processing software is very strict with small differences in these codes. It will reject incorrect and incomplete codes. Also, if they deny your visit or service, it might be due to incorrect code. Otherwise, the cause is an incomplete one. Be patient with this, and contact the billing department for clarification.

Obtain Preauthorization
Insurance companies require you to submit a preauthorization request. It should come with an explanation of why you need a medical procedure. Thus, you need preauthorization for your tests, medications, and other procedures. Ask your insurer in advance if preauthorization is necessary. Also, know whether your health plan requires specific specialists.

Understand the Benefits of Multiple Policies
After you've coordinated the payment process, make sure that your primary insurer pays first. However, if you're still an employee with Medicare as your insurer, your employer's plan is the primary plan for companies with 20 or more employees. However, if your employer has fewer than 20, then it's secondary. The point is that if you have more than one insurer, you should ask both insurance companies on how you can coordinate the benefits.

Prepare for Rejection of Some Claims
Insurance companies in some states will reject claims that involve automobile accidents or work-related injuries. If a third party is responsible, the insurer will more likely reject it. An example is the owner of the grocery store where you slipped on the wet floor. That claim should fall under the grocery store’s general liability insurance policy. Discuss things with the insurer if anything gets confusing.

Some Final Words
It’s not easy to file an insurance claim. The most important thing is that you understand the procedures. Let your insurance company assist you when making claims. Make sure too that you always have alternatives in case they reject your claims.

At Crown Affordable Insurance, we aim to provide comprehensive insurance policies that make your life easier. We want to help you get the insurance that fits your needs. You can get more information about our products and services by calling our agency at (816) 630-3278. Get your free quote today by CLICKING HERE.