Health Insurance: Take Action!

You will probably have some medical bills your insurance will not pay at first. This is called a denial of coverage. When this happens, you can appeal the decision. Call your insurance company and find out why there was a denial of coverage. Also, ask what you need to do to appeal the decision. Your doctor can help. There are many things you can do before you appeal a denial of coverage. Staying organized can help. Have a file with your insurance statements that show payment and match them to the medical bills. Remember to copy and date anything you send to your insurance company. Learn your insurance by highlighting the sections that apply to your condition. Review your medical bills and write down your clinic visits, prescription drugs, and the result of your treatments. Keep notes when you talk with your insurance company. Write down the date, time, first and last name of the person you spoke to, what you talked about and what you agreed to. Ask the person you spoke with to send you, by email or U.S. mail, what you agreed upon in writing. Doing all of this will help if you have to appeal a denial of coverage.

Asking your insurance company for a case manager to assist you may be helpful. A case manager can act as your representative at the insurance company. You may need to tell your case manager about your condition and what health care you or your child needs. The case manager and you can become ateam to work toward meeting the costs of your health care.

Key Points:

• Taking Action
• Be organized
• Keep forms and bills in one location
• Highlight sections of your plan that relate to your condition
• Review medical bills
• Write down clinic visits, treatments and drugs
• Keep a record of conversations withinsurance company
• Work with a case manager

Source: The Cystic Fibrosis Foundation