“straight, simple and to the point: five easy steps to help you file a health insurance claim efficiently.”
When handing over your insurance ID card isn’t enough to secure direct billing, it’s important to know how to file a claim with your insurance company. this process can reimburse you for any out-of-pocket visits and ensure that your medical bills are paid as quickly as possible.
Reading: How to file medical insurance claim
step 1: collect your itemized receipts
To file a claim, you must first obtain an itemized bill from your physician or medical provider. This bill will list all the services you received along with the cost and a special code that the insurance company will need to pay your claim. Obtaining these receipts is relatively easy: just call your provider and let them know you’re filing an insurance claim. from here, they should immediately submit their itemized receipts after providing a few pieces of information, such as their full name and date of service.
step 2: fill out a claim form
A claim form is the document that tells your insurance company more details about the accident or illness in question. This will help them determine whether or not the expenses you are claiming are covered by your insurance plan, so the more information on this form the better. Please note that each form should have instructions for completing the form and instructions on how and where to submit it, but if you have questions, simply contact your insurance company.
Typical sections of a claim form:
- personal information such as your name, address and date of birth
- insurance information, such as a policy and group number
- reason for your visit, including background information about your condition
- provider information, including physician’s name and address
- out-of-pocket costs you’ve already paid
step 3: make at least 1 copy
As a precautionary measure, it’s always a good idea to make copies of your entire claim before submitting it to your insurance company. Please keep an extra copy of the completed claim form as well as your collected receipts in case there is a complication with your claim.
step 4: review, call and send
When you have all your documents complete and ready to be submitted, call your insurance company. let them know you will be submitting a claim form and review the documentation you are about to submit. be sure to ask them if there are any additional documents that need to be submitted and how long you expect for the claim to be paid.
When you are absolutely sure you have everything in order, you can submit your claim form and accompanying documentation to your insurance company. if you need an address to send it to, check your claim form. In most cases, you are expected to mail in your claim, but in some cases you may be able to email or fax your documents.
step 5: wait
now there is nothing to do but wait. Keep an eye on your calendar, noting the claim date your insurance company gave you when you called. If you don’t receive your claim payment within the timeframe you’ve been given, contact your insurance company and let them know. When you speak with someone, be sure to write down the date, time, and the full name(s) and title(s) of the person(s) you speak with to create a paper record, which you may need if further problems arise with your claim.
If you’re curious about what you’ll receive from your insurance company after you file a claim, check out our helpful tool for understanding your explanation of benefits (EOB). Otherwise, be aware that your insurance company may request additional documents, such as your medical history records, to support your claim, so it’s important to be aware of the process. As always, be sure to contact your insurance company directly if you have questions about filing a claim, claim status, or your EOB.
return to our “explained insurance” section for more information and help