Out Running the Insurance Companies

Here's the game.  The insurance companies are so good at wearing the consumer down hoping you will give up!   I find the more you call an insurance company's customer service line, the more new information you can get.  Each representative has a different spin on the information and sometimes will  feed you a valuable tidbits of information.  If I am waiting on a bill to clear or an the appeals process to conclude, I will call twice a week.  For instance, I had a client who was denied service because the doctor and hospital had billed incorrectly.  All the bills had to be resubmitted.  Then the insurance company said the doctors were out of network.  I called to find the status of the bills.  The person I spoke with told me, " This is odd.  The doctors all have contracts with us"   What a surprise.  I am sure I wasn't supposed to know that because now, the process couldn't be drawn out.  The bills were sent for readjustment and payment.  Of course, it will take another 2-4 weeks.  The process could have dragged out for 8 weeks with an appeal needing to be filed.  The key is to know it is going to take time to get what you want.   Also, know your policy.  It can give you power when you can quote it.  Advocates
are your best resource to help guide you through the insurance maze.

 

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Comments

  • 2/5/2009 4:52 PM Affordable Health Plans wrote:
    I think insurance companies are experts at stalling and keeping consumer money. In the insurance billing system, an advocate is really needed these days. It would be so easy to get just one code number wrong and that would be easy to overlook.

    It looks like you are providing some valuable services and I wish you all the best with your advocacy business.

    Steve
    Reply to this
    1. 2/5/2009 6:52 PM HealthCare Whisperer wrote:
      Thank  you Steve!  I spend many hours talking to different insurance companies.  I wish there was a handbook people could use to not get slammed.   I have come to enjoy this part of healthcare navigation especially getting bills reduced.   I never want anyone to pay anything
      except copay or coinsurance and even then I do my best to reduce the fees!  Hari Khalsa

      Reply to this
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