INSURANCE

Q:

What’s the best way to cut through the red tape when I need answers from my health insurance company?

A:

The first person you should turn to with your insurance questions is your agent. As an agent, I work with insurance companies every day so I know who to contact regardless of how complicated an issue may be. It is part of my job to get answers for my clients.

If you do not have an agent, here are a few tips to make the process of working with your insurance company a bit easier.

1. Have all pertinent information handy including your insurance card, your Medicare card (only if you are on Original Medicare), your billing statements and Summary of Benefits. If you are looking into a specific procedure ask your physician for the diagnostic codes he or she used.

2. Familiarize yourself with the basics of your plan, including your co-pays, cost of visits for specialists and out of pocket maximums. 3. Be prepared to take notes. Many people find it handy to keep a notebook specifically for this purpose. Note the date of your call, the person you spoke with and what they advised. These records will be helpful if your concern requires more than one call.

4. If the insurance company representative promises to get back to you with answers, ask for a date. Note their name and phone number on your calendar and be prepared to follow up with them.

5. If the insurance company agrees to make an exception of any kind, ask for that agreement in writing. 6. When you are calling for another person, be ready to have them get on the phone to let the insurance company know it is okay for you speak on their behalf. If you will be routinely handling someone’s insurance matters, find out what forms or procedures are required for you to become the ongoing representative of that person.

7. If you are discussing complicated medical issues, ask to speak to a nurse. Many case managers at insurance companies are RNs who are accustomed to discussing medical issues.

Patience and persistence are often required in order to get complex insurance matters resolved. If you prefer to have someone else handle the legwork for you as I do every day for my customers, give me a call at 440-255-5700. I represent many of the nation’s most respected insurance companies and will help you find the plan that works best for you.