In this article today I would like to discuss several tips, tricks, and tactics that just about anybody can use to help get their HMO to pay their insurance claims as fast as is possible.
Times are pretty tough for just about everybody. The recession that began towards the end of 2008 and has continued into 2010 is making life difficult across the board. People are losing their jobs and the unemployment rate is skyrocketing and inflation seems to be rearing its ugly head as well. Likewise, we are in the midst of a nationwide health care debate that may or may not change the face of the country.
But in the meantime anything you can do to help your finances is beneficial. One way to help your finances is to make sure that your HMO pays your claims as fast as possible, and that's what I'd like to talk about today.
When you get right down to it, it seems like the larger the amount of a claim that you file with your HMO, the less likely they will be to pay for most of it. This can be incredibly frustrating, I know! The thing about insurance companies, and managed care companies is that they are counting on you to accept what they decide to pay because most people do.
So what can you do to make sure your claim gets paid, and gets paid in a timely manner? The most important thing you can do is take an active role in the claims process itself. With the usual insurance policy you personally file your claims but this is not the case with an HMO because they handle your claims for you. The problem is, if something goes wrong the HMO may deny the claim or may start dragging their feet when it comes to paying out.
If this is the case there are a few things that you can do. First ask the HMO to send you copies of all claims filed on your behalf. They will do this. When you get those copies, take care in reviewing them and look for any missing information or any other problems that are obvious. If you do find missing information or problems, forward any missing information to the HMOs home office as soon as you can.
Find out who the claims officer or claims examiner who is assigned to your case and don't be afraid to call them up and talk to them. Ask them to explain themselves. They should be able to explain any decision they made especially if you believe that they are being unfair. If this doesn't work, move up the chain of command and talk to their supervisor.
Finally, don't take their first "no" as the final answer for your claim. You can file an appeal and you should do so immediately. Be sure to follow the complaint procedure that is outlined in the HMO handbook that you received when you began the HMO. Be sure to file any appeals using registered mail with the return receipt requested option so that you have a record that you can produce in the future.
So there you have several tips, and tricks that you can use to make sure your HMO pays out promptly and correctly.
J.P. Morton runs a men's wool coat web site where he also reviews the best men's leather coats. He has been an article writer online for well over 10 years and also enjoys rock climbing and white water rafting.
