What are some tips for communicating with insurance companies?
Question 4 of 7 (use "Last" or "Next" buttons to see more)
Last Update: August 16, 2006
If you are like most people, you have called your insurance provider with a question, been put on hold, and finally reached a representative only to discover you did not have all the necessary documents in front of you.
It can be easier. Below are some tips to help you get the best results from your phone calls. Remember: If you have questions about your insurance coverage, whether you have Original Medicare or get your benefits through a Medicare private health plan (such as an HMO, PPO or PFFS), you have the right to get answers.
Before you pick up the phone
to call the insurance company, either on your own behalf or on behalf of a loved one, make sure you have carefully read all the documents you want to discuss. Make sure you have access to the following information:
- the insured personís birth date
- insurance policy number and social security number
- name and address of organization that sent the bill
- total amount of the bill
- diagnosis code on the bill
- (if you are questioning an insurance payment), the Medicare Summary Notice from Medicare or the explanation of benefits from your Medicare private health plan
- a list of your questions
Once you are on the phone:
If the insurance representative asks you to submit additional information:
- Always write down the name and telephone extension of the person handling your phone call. If someone is unwilling or unable to help you, ask to speak to the supervisor.
- Take good notes, including the date of the call and the information you were given, including what you were told would be done or you should do.
- Be patient, since you will probably spend some time navigating automated telephone menus and waiting on hold.
- Send it right away!
- Keep a copy of anything you send.
For tips to help you exercise your Medicare rights, click on the link in the GO TO box.
For more information on your Medicare Summary Notice, click on the link in the GO TO box.
For information on what to do if Original Medicare wonít pay for care you received, click on the link in the GO TO box.
For more information on what to do if your Medicare private plan says no to the care you need, click on the link in the GO TO box.
This information was provided by the Medicare Rights Center (MRC), the largest independent
source of health care information and assistance in the United States for people with Medicare.
Founded in 1989, MRC is a nonprofit organization that helps older adults and people with
disabilities get good, affordable health care.
You can learn more about MRC at www.medicarerights.org