How To Appeal When Your Medical Insurance Doesn't Pay

Here is an intresting article which I wanted to share with all the readers which I found really intresting.
Have you ever received a bill from your doctor and stopped breathing? Have you wondered why you are receiving a bill when you have medical insurance? Have you asked the question, why am I paying this astronomical monthly payment?


MEDICAL BILL:

When you receive a medical bill from any provider; example, doctor, hospital, lab or x-ray is it paid correctly? Has any payment from your medical insurance been paid to your bill?

When a payment has not been paid or very little and you call and speak to a representative from you medical insurance company and the doctor's office, what is the next step?

If you're medical provider is going to appeal your bill or claim, great. Just make sure they follow through in a timely manner. Some appeals are time sensitive.

If you're medical provider says it is your responsibility to appeal your claim keep reading.

APPEALING YOUR MEDICAL BILL:

1. Write a letter and explain why you feel your claim was not paid correctly or was not paid.

2. Make sure you have your name, address, city, state, zip code and telephone number on your letter.

3. The name of the person insured on your insurance plan. (Guarantor)

4. The name of the person that was seen by a provider.

5. The date of service the medical care was obtained.

6. The place of service the medical care was obtained.

7. Attach a copy of your explanation of benefits (EOB) you received from your insurance company.

8. Attach any correspondence you received from your insurance company prior to receiving the final explanation of benefits.

9. Attach a copy of your medical insurance card.

10. Attach a copy of all your medical records pertaining to this date of service. Include x-rays, lab slips, anything that will present your case completely with one viewing.

SECRET:

Insurance Companies need your date of service and place of service. This is how they track all your medical care by each individual provider.

Example:

You were seen by your doctor that morning in her office. That afternoon you were admitted to a hospital. Now you have two different providers on the same day.

Try to make your presentation as professional as possible. The person that will be reviewing all your information will expect to see your entire case presentation in one sitting.

If the appeal board needs more information from you, they will probably send you a letter or phone you.

EXCEPT:

You will not win an appeal if your deductible or co pay was not met. Another denial is a non-covered service. With this denial your medical provider can help you make a decision before you go through the entire appeal process.

Sometimes this is not entirely true and an appeal would be perfect.

So I say go for it. Appeal your claim. Pour your emotions and passions out in your letter to the appeal board.

If you do not have a computer to type your letter hand write it. Just make your letter legible. Sometimes a hand written letter is more effective.