Dealing with Health Insurance Companies

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* Understand that the insurance providers have contracts with doctors, hospitals, and other providers. Health care providers have agreed on certain fees for services with these insurance companies. As long as you get your care from a plan provider, you typically will be responsible only for any cost-sharing your plan requires. That doesn't mean the doctor won't try to get you to pay additional charges. They often will. Keep the explanations sent by the insurance company and present them to the doctor's office. Explain that you are aware they are under contract with the insurance agency.
* Understand that the insurance providers have contracts with doctors, hospitals, and other providers. Health care providers have agreed on certain fees for services with these insurance companies. As long as you get your care from a plan provider, you typically will be responsible only for any cost-sharing your plan requires. That doesn't mean the doctor won't try to get you to pay additional charges. They often will. Keep the explanations sent by the insurance company and present them to the doctor's office. Explain that you are aware they are under contract with the insurance agency.
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* Never use the words "experimental" or "investigational" or tell them that you want them to pay for a clinical trial. Instead, try saying, "There's medically necessary treatment that I'm seeking." Remember, words have power and insurers are all about finding limitations and exclusions if you say the wrong thing.
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* When dealing with an insurance company, never use the words "experimental" or "investigational" or tell them that you want them to pay for a clinical trial. Instead, try saying, "There's medically necessary treatment that I'm seeking." Remember, words have power and insurers are all about finding limitations and exclusions if you say the wrong thing.
* [http://www.gainsurance.org/consumerservice/Complaint.aspx Georgia Insurance Commission Complaint system.]
* [http://www.gainsurance.org/consumerservice/Complaint.aspx Georgia Insurance Commission Complaint system.]
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[[Category:Health Insurance]]
[[Category:Health Insurance]]

Revision as of 15:12, 4 February 2011

When the finance department at Ledet Training negotiates with health insurance providers, we fight over details. However, it's important for covered individuals to understand how to use this benefit. Here's some tips on how to use health insurance.

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