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How To Submit a Claim

When you request a reimbursement from your health insurance for a health service you have already paid for, it’s called a claim.  It can all be a bit overwhelming but it’s not as scary as it sounds!

What are your options to file a Health Insurance Claim?

There are two different ways you can submit a claim to your health insurance company.

  1. In todays technological world, most insurance companies handle claims online.

  2. The other is sending paper forms through the mail.

  3. Or it could be a combination of both online and paper.

What kind of information do you need to submit a claim?

Obtain an Itemized Receipt or Superbill from your Doctor

This Superbill will have a detailed report of that days provided services along with the codes that the insurance company will need to process your claim. Be sure to keep a copy of this for your records, the insurance company will more than likely need the original.

You will need to obtain a Claim Form from your insurance company.

Either an online form that you print out, fill out online or request a form through the mail.

Contacting your insurance company.

There are many different Insurance Companies and they may have their own slightly different protocol on how to submit a claim. In order to find how your company would like you to proceed you must do one of the following to.

  1. Call your insurance company. Your insurance card should have a Member Services or Customer Services number on the back. Call this number and follow the prompts to filing a claim or select to speak to a representative. They will be able tell you how to get your Claim Form.

  2. Most Insurance Companies have a Website therefore, you should be able to download a form right off their website.

Claim forms a fairly self-explanatory they will ask for items like;

  1. Your insurance policy number, group or member number (located on your insurance card).

  2. Do you have co-insurance?

  3. What the visit was for (accident, workers compensation, well care and so on).

  4. Who was the visit for (the primary insured, a dependent or spouse or domestic partner)?


The advantages of making your claim online.

The most notable advantages of filing online, is that the payment of your claim is significantly faster! Getting your claims reimbursed faster is worth the time it takes to set up an account on their site.

Filing claims by mail.

If you do have to file your claim by mail always remember to make copies of your originals. Be sure to review everything you have entered into your forms to avoid any unnecessary delays in reimbursement. Mark your calendar making note of the day you sent your claim in, if you have not received any correspondences in a reasonable time, contact your insurance company to find out the status of your claim.

pf 2019

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