Keep These 4 Tips In Mind When Filing Health Insurance Reimbursement Claims

Keep These 4 Tips In Mind When Filing Health Insurance Reimbursement Claims

Claims in health insurance can be either one of the following two types – cashless or reimbursement. For a cashless claim, you need to apply for pre-authorization with your health insurance provider.

In case of reimbursement, you make the payments on your own for treatments received and later apply for compensation under your policy. 

Cashless claims can be made at network hospitals. However, if you miss the deadline for filing a cashless claim, you have to opt for reimbursement instead. Also, if you opt to get treated at a non-network hospital, you need to file for reimbursement.

Now, if you are making a claim on health insurance for the first time, the entire process might seem a bit confusing for you. In this article, we take a look at a few tips that will help you when filing a reimbursement claim on your health insurance.  

health insurance

The first step to take when raising a claim is to call up your insurer and ask them their exact process for filing a claim. While the overall process of raising a claim in health insurance is mostly standard across insurers, there might be slight variations.

To ensure that you do things just right, call up the customer care department and ask them to outline the exact steps you need to take while filing a claim. They will also help you with the document list and answer any questions you may have – such as how long it will take for your claim to get verified and processed. 

  • Keep all paperwork in order

Do keep any paperwork pertaining to the hospitalization safe and in order. This will help you maintain a strong case when raising a claim.

Some of the documents that you will need to keep safely include the hospital case papers, bills, receipts for purchases, diagnosis reports, discharge summary, and any other paperwork given while at the treatment center. Also, keep a few photocopies of each of these handy. 

  • Cross-check the reimbursement form  

The reimbursement form will be available at the insurance provider’s office. You may also download it from their website. Do fill-up the form carefully and cross-check to verify that the facts and figures match perfectly with the supporting bills and documents you submit.

You would not want a small error in filling up the form to stand in the way of your health insurance claim getting processed smoothly. 

  • Know policy exclusions

Before filing a claim for reimbursement, make sure that you know what gets covered under your policy and what doesn’t. Medical insurance policies have a certain number of exclusions, such as treatments that are not covered.

If you raise a claim for any of these, your request for reimbursement will get rejected after you have gone through the entire process of filing the paperwork. That can be quite disappointing. So, do read the policy fine print carefully and raise a claim accordingly.

We hope that these tips prove helpful when you make a claim on your health insurance. Do remember to keep your coverage active to always stay protected. Good luck!


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