How Are Health Insurance Claims Handled?

Health insurance is indeed a blessing, but sometimes it can be a real headache, too, when your health insurance provider denies a claim you’ve made, or there’s some sort of problem with a health insurance claim that you’ve filed.

The handling of health insurance claims is usually problem-free, but for those times when it’s not, you need to know what to do.

Handling health insurance claims works in a few ways.

Option One: The Doctor’s Office Submits Claims

The most common method for handling health insurance claims, and far and away the easiest one for health insurance plan members, is that the health insurance claim be submitted directly to the health insurance provider by the doctor or medical facility that you’ve visited. You simply walk in to your appointment or visit, fill out a form or two, or sometimes just show your health insurance identification card, and then see your doctor or other medical professional. After that you just walk away while the people who work in the doctor’s office or medical facility submit a payment claim to the insurance agency.

Option Two: You Submit Claims Directly

A less frequent scenario is one where you have to pay for your visit to a doctor or other medical professional yourself, and then have to submit a health insurance claim to your provider. When this happens you need to have your itemized receipt from the doctor or medical facility which you visited, and then submit it along with your health insurance claim paperwork. It is critical that you have the right paperwork for the health insurance claim that you’re making.

If you have any questions about filing a health insurance claim, be sure to consult with a representative of your health insurance provider. They are paid to answer your questions and help you.