How to Handle Health Insurance Reimbursement For Seniors
Health insurance reimbursement for seniors can be complicated. As a result, keeping track of expenses is important. Also, with multiple doctors and medication to track you must stay organized. In order to make things easier, here’s your guide to health insurance reimbursement for seniors and caregivers.
Why You May Need to Submit Health Insurance Reimbursement
For seniors who have Medicaid or Medicare, most providers submit billing on their behalf. For example, services like testing, doctor visits, and hospital stays get submitted. However, insurance plans do not always cover all costs. Because of this, people usually plan for out-of-pocket costs. Insurance care may also reject claims submitted by service providers. For example, here are some common reasons a claim may get rejected.
- Lack of medical necessity. The insurance company deems the service not necessary based on the medical diagnosis.
- Claim filing errors. For example spelling and missed deadlines.
- Charges not covered. For example treatments that are not authorized by the plan. For example elective care or experimental treatments.
How to Submit a Reimbursement Claim
The easiest way to submit a reimbursement claim is electronic. Which is usually completed through the carrier’s website. Once you are set up in the system and logged in, simply answer the questions asked. Next, attached itemized receipts. Finally, add documentation from doctors or other providers and submit.
Some carriers want the original receipts and documentation sent to them. As a result, you should Fill out as much information as possible. You can complete it online and submit the supporting documentation via mail. Don’t forget to make copies of the documentation.
The Complicated Part
The process of submitting a claim is straightforward. However, dealing with the insurance company is not. As a result, be sure you are contacting the right department. Also, make sure to get the right documentation for a claim. usually takes patience and persistent follow-up especially if multiple providers are involved.
Disputing a denied claim is typically the most difficult part of getting health insurance reimbursement. Insurance carriers require claims to be filed in a very specific way to fulfill their requirements. Even supporting documents need to have specific words or phrasing in them.
You may find yourself in an endless loop with the insurance company. An Aging Care Manager with billy pay experience can help. Local aging care managers have experience dealing with insurance companies and reimbursement claims. Many have a background in health care as a nurse or a social worker. As a result, they know what questions to ask. Also they know how to make requests, and get claims approved.
Are you struggling with health insurance reimbursement? If so, visit AgingCare.io. You can connect with a care manager in your area. As a result they can help you with reimbursements for your loved one.
Please note, AgingCare.io is currently available only in NYS and CT; other states will be launching soon.