What Should I Do If My Health Insurance Company Sends Me a Check? There are a few things to consider before cashing it. For starters, you may be liable for fraud if you have a higher balance than you can handle. If you’ve recently visited a doctor and were billed directly, you may have a claim that requires reimbursement from the insurance company. The reason for this could be anything from an error or miscommunication. In either case, you should check the Explanation of Benefits (EOB) carefully.
What Should I Do If My Health Insurance Company Sends Me A Check?
You Might Be Liable For Fraud
You might be liable for fraud if you received a check for medical services without contacting your insurance company first. Most insurance companies don’t report fraud unless a person intends to defraud them. Most cases are handled internally as abusive billing. Fraud investigators work with insurers to resolve billing disputes. In the past five years, only one case of fraud was prosecuted involving a private health insurer.
The health insurance industry has a tepid response to this problem. In Texas, for example, a personal trainer who didn’t have a medical license claimed to be a doctor for four years. He then walked away with $4 million. The health insurance company is now being sued. This case is a cautionary tale for health care professionals. But the healthcare industry needs to take action now and do everything possible to protect consumers from fraud.
By understanding the insurance claim process, you can avoid the fraud and protect health insurance of your family. Here are step by step for claims:
- Use the claim form provided by your benefits plan.
- Include all pertinent information, including procedure codes (which you can obtain from your doctor’s office).
- If you’re filling out the form by hand, make sure to write legibly.
- Fill out your paperwork as soon as possible and within the deadline.
- Preapproval should be included (if needed)
- Check to see if your plan covers the treatment claim.
You Might Want To Read The Explanation Of Benefits
You may be wondering why you might want to read the Explanation of benefits (EOB) of your health insurance company. This statement, which is not actually a bill, explains how your health insurance plan pays for certain services and products. This statement is generated each time you submit a claim for medical care or products. It is not the same thing as a bill, but it shows the breakdown of costs associated with recent medical care. Reading it will help you identify potential issues with your insurance plans and will make your life easier in the long run.
When you receive your bill from your health insurance company, be sure to review it. Many insurance companies have member services that can answer questions about your bill or Explanation of Benefits. Make sure to compare your EOB with your actual bill. The bill should include the items and services you received. The bill should also show how much your health insurance company paid for those services. Depending on your coverage, you may be able to obtain more than one Explanation of Benefits each month.
You Might Want To Hold Off On Taking A Doctor’s Payment Plans
Sometimes you might want to wait to pay a doctor until your health insurance company gives you a check. If this is the case, you should notify the hospital or clinic so they can hold off on sending you a bill until the check clears. If you have a medical insurance policy, they will send you a statement or “explanation of benefits” that explains when they’ll pay their portion. Typically, your doctor or provider will submit the claim form on your behalf, especially if they are part of your plan. You may have to do this yourself in rare cases when visiting a doctor who is not covered by your insurance.
To sum up, in case you reieve a call or a message from your insurance agency, you should identify the information that they ask you to reply. Perhaps, they ask you about the cost amount, your health plan. If you want to find more about this insurance plans or resources, please search on our website to gte more information.