If you’ve ever had to wait for health insurance to process a claim, you know how frustrating it can be. You’ve done your part by paying your premiums on time, but for some reason, the insurance company is taking its sweet time to reimburse you for your medical expenses. Unfortunately, this problem is all too common. In fact, a study by the National Association of Insurance Commissioners found that over 20% of Americans have experienced problems with their health insurance claims in the past year. So what can you do if health insurance keeps delaying payment? Here are a few tips to help you get the reimbursement you deserve in a timely manner.
Check your policy’s grace period
If your health insurance policy has a grace period, that means you have a set amount of time after your premium is due to make a payment before your coverage lapses. Grace periods typically last 30 days, but some policies may have shorter or longer grace periods. If you’re having trouble making a payment on time, contact your insurance company to see if they can extend your grace period.
Understand your insurer’s internal appeals process
If you’re having trouble getting your health insurer to pay for a treatment or service, you may be able to file an internal appeal. Internal appeals are handled by the health insurance company itself, rather than by an independent third party.
To start an internal appeal, you’ll need to contact your health insurance company and request a copy of their internal appeals process. This process will outline the steps you need to take in order to file an appeal.
Once you’ve filed your appeal, the health insurance company will review your case and make a decision. If they deny your appeal, you may be able to file an external appeal with the state insurance commissioner’s office.
File an external appeal
If you’re still waiting on a payment from your health insurance company and you’ve already gone through the internal appeals process, you may want to file an external appeal.
An external appeal is when you ask an outside organization, such as the state insurance department or a third-party administrator, to review your case. This can be a last resort if you’ve already tried everything else and you’re still not getting anywhere.
To file an external appeal, you’ll need to gather all of the documentation that you’ve already submitted to your health insurance company, as well as any correspondence between you and the insurer. Once you have everything together, you can submit it to the state insurance department or the third-party administrator for review.
It’s important to keep in mind that filing an external appeal can be a lengthy process, so it’s not always guaranteed that you’ll get a decision right away. But if you’re still owed money from your health insurance company, it’s worth giving it a shot.
Speak to your state’s insurance commissioner
If you are having difficulty getting your health insurance company to pay your claims in a timely manner, you may want to contact your state’s insurance commissioner. The insurance commissioner is responsible for regulating the insurance industry and handling complaints from consumers.
You can find contact information for your state’s insurance commissioner on the National Association of Insurance Commissioners website. Be sure to have all relevant documentation handy when you make the call or send an email, as this will help the insurance commissioner investigate your case.
Hire an attorney
If your health insurer keeps delaying payment, it may be time to hire an attorney. An experienced attorney can help you navigate the insurance appeals process and get the coverage you need.
When you’re dealing with a health insurance dispute, an attorney can:
· Review your policy and determine if the insurer is acting in bad faith
· Help you file a formal appeal with the insurer
· Negotiate with the insurer on your behalf
· Represent you in court, if necessary
Conclusion
If you’ve been experiencing delays in payments from your health insurance company, don’t despair. There are a few things you can do to try and speed up the process. First, make sure you have all the necessary documentation in order. If something is missing, that could be the reason for the delay. You can also call or email your insurance company to ask about the status of your claim. Finally, if you’ve been waiting for a long time without any luck, you can always file a complaint with your state’s insurance commissioner.
