1. Don’t Give Up
Your health insurance rep will probably tell you yes or no about your policy questions as if there are no variations in how these policies can be written. In truth, there is plenty of variation in how the policies can be written, and it can benefit you to try a different representative to see if you get the same result. In many cases, the result will be different, and also to your benefit.
2. Do Yourself a Favor and Have Them Write it Down.
You can bet that insurance companies will be keeping detailed records of every detail of your care. In order to consistently give yourself the best results when dealing with any insurance company, it is best to have them write it all down for you. What you can do is keep copies of all of your correspondence. Also, get names from the people you deal with on the phone and take notes on the details of the conversations. If an insurance company representative makes a verbal commitment to anything, make sure that you also get it in writing.
3. Out of Network Costs Do Not Always Involve Choice
Many consumers of medical services will be seemingly stuck with out of network costs by no choice of your own. For example, you may have a back surgeon of your choice and who is in-network, but he or she works with other doctors who bill you separately, and those doctors may actually be out of network. If you are stuck with out of network costs because of situation where you did not get to decide on that service, then you may be able to mitigate the costs. You really need to be persistent and talk to as many people that you can until you get the result that you want.
Commonly, emergency medical services may fall into this category, and if out of network costs are incurred for emergency services, you may be able to shield yourself form liability. Check the details of your policy and ask questions until you are satisfied with the answer.
4. Insurance Companies Aren’t Intimidated by You, but…
If you are feeling like you are being ignored or burned in some way by your insurance company, you will be doing yourself a favor if you involve your Doctor or even your congressman when dealing with your insurance company. This is not a first step, but if you are really feeling the frustration then this could work. For example, have your physician contact your insurance company on your behalf if possible. If you are exchanging emails with your insurance company and you feel they are doing you wrong, then cc your congressman on the email.
5. Use a Patient Advocate
A patient advocate is a great idea if you are in some serious dealings with your insurance company. Patient advocates are experienced at negotiating the best possible coverages and settlements for their customers.
Finding a patient advocate: Try the website, patientadvocate.org