Have you ever found yourself in a situation where your health insurance isn’t covering what you expected it would? Sometimes mistakes are made, and just because your insurance carrier isn’t paying for something, doesn’t always mean that you will be left to foot the bill. There are steps that you can use to take action and to ensure that you receive the coverage you purchased. By filing an appeal or disputing a health insurance claim, you can hopefully change the outcome. Filing an appeal can sometimes feel like a daunting task and can seem like a hassle, but by following these tips, we hope to ease the process for you, so you know what to expect.
1. Read Your Policy
The most important thing that you can do when you are filing an appeal to a health insurance claim is read your policy. You should read your policy when you purchase it, then re-read from time to time so you are refreshed on the breakdown of your coverage. It’s also a good idea to review your policy before having any procedure. Doing so could help avoid a situation where you need to file an appeal. It’s also important to assemble all important paperwork, and keep an organized record of the details of your case (Who, what, when, where, why, how).
2. Try to Have a Main Contact at the Carrier
Having one contact can make the process easier for you. By doing this, you will not have to keep explaining your case to every person on the phone. Also, you may be able to build some rapport with your contact, which may inspire them to go above and beyond to help you.
3. Be Patient Approach in the Right Manner
Patience will be required whenever filing an appeal as the process can take some time. The insurance company will conduct extensive research to determine if your appeal is worthy. Going into the situation knowing that the process can take some time may help you with expectations. It’s also important to approach the situation in the right manner. In many situations in life, handling something in a positive, respectful manner can get you a lot further than having a negative attitude or having a chip on your shoulder.
4. Contact Doctors and Hospitals
Be prepared to contact doctors and hospitals, and do a little bit of investigating on your part. You may come to find that there was an issue with the provider and it was just a simple error.
5. Act fast
When filing an appeal, there may be a limited time that you have in order to file. Similar to a return policy when you buy at a retail store, you may only have a certain number of days to make an appeal.
If your claim appeal is with a network provider, by contract the insurer usually can only pay the network provider, not you. So if you pay the bill and are awaiting reimbursement, it can be complicated. Also, if you decide to not pay any bills and wait for the appeal process to finish, your credit may take a hit. Talk to your doctor or office that you are working with and let them know the situation. Try to keep them from sending your outstanding bills to collections.
If you have any more questions about what steps you should take when filing an appeal, please feel free to ask us or comment below! Having proper insurance is important whether you are at sea, or docked at a shipyard. MHG is your specialized broker when it comes to crew insurance. Our insurance specialists have the knowledge and experience to find the policy that works best for you. If you are interested in purchasing, or have any questions about yacht crew insurance or travel insurance, please contact us at +1 954 828 1819 or +44 (0) 1624 678668 or visit us online at mhginsurance.com. For more information on common yacht crew insurance terms, read our previous blog, “Yacht Crew Insurance Terms 101.”