Health Insurance Claims FAQ

The health care system in the United States is not exactly known for being a smooth, well-oiled machine. It’s big, bulky and unbelievably expensive — and getting more so every day. One aspect of the nation’s mish-mash of health care plans and programs is the claim filing process. Sometimes it’s easy, other times it’s a complicated mess that can turn into a huge hassle for the person submitting the claim.

We’ve answered some common questions about filing health insurance forms below:

Who submits my forms?

The vast majority of the time, claims to your health insurance provider will be submitted by your doctor’s office or by the medical facility you visited. You won’t have to do a thing except show your health insurance identification card.

If you do have to submit your own health insurance claim to your provider, you need to submit an itemized copy of the receipt you got from the doctor or medical facility you visited.

What about my co-pay?

Sometimes a co-payment is required for the visit or procedure. In most cases, you simply pay it and you’re done. Be sure to keep your receipt with you, just in case.

Most health insurance claims are really this easy.

What if my bill comes and it’s wrong?

Generally speaking, if there is a discrepancy between your bill and what your health insurance provider thinks it’s expected to pay, you will have to pay the doctor or medical facility for the bill. After that, you have to file a health insurance claim and work it out with your health insurance provider.

Health insurance claims can be tricky, and complicated, and very difficult to resolve. However, the vast majority of health insurance claims are processed easily and efficiently and do not result in any kind of hassle. If you have questions about filing your health insurance claims, be sure to consult with a representative from your health insurance provider. They are paid to explain health insurance claims and other policy issues to you.