Get Your Claims Covered

Appealing for a claim from your health insurance? Review it to avoid denials.

- Debbie Koenig

If you have a health insurance, at some point you may receive a bill for something that you thought would be covered. A 2017 study from the Doctor-Patients’ Rights Project found that 24 per cent of people with chronic illnesses (including diabetes) had a claim denied by their insurance company. But among those who appealed the decision, the denial was overturned nearly half the time. OŠen people assume the insurance company made a mistake and will fix it, but without an appeal that does not happen. “In case of denial, one can re-apply but chances are that once the claim is denied, it will be denied again. In such a scenario, customers can file a case against the company if they are not satisfied with the reasons given by the insurance company.” says Rikita Kharkwal, Senior Associate, Corporate Business Group, PolicyBazaar.com on appealing against the denial of the claim.

PREVENTION IS THE BEST MEDICINE

There are a few points that one should take note of while applying for the claim or before buying the policy. The best way to ensure that your claims are covered is to double check beforehand that all the diseases you wish to be covered in your policy are there on the list. For that make sure to call your insurance company. Your doctor does not know the particulars of your plan, but your insurance company can tell you exactly what is covered in your policy, as well as which providers and pharmacies are in-network. Call to check what is covered before scheduling tests and procedures, or filling new prescriptions.