While health insurance can be a necessary part of protecting both you and your loved ones’ physical and financial wellbeing, it can get technical at times – and cause the occasional headache or two. When you really need your health insurance to work for you is when you’re feeling ill or you have to take a family member to the doctor (or the emergency room, God forbid!). These times are stressful enough and no one wants the extra stress of figuring out the billing process or other administrative matters. Here, the team at APRIL International share some helpful tips about what we can do ahead of time to make the claims process less stressful.
#1 Understand your cost-saving options
Many plans offer one of two ways to reduce your overall premium by making you responsible for part of your medical expenses; this is done either through deductibles or co-insurance.
- Deductibles: Almost always applied annually, a deductible is the amount of money you’ll need to pay before your health insurance plan covers the rest.
- Co-insurance: Also known as a co-payment, this means that you will have to pay either a percentage or a fixed amount for medical treatments.
What’s even more important than understanding cost-saving options is understanding which parts of your health insurance plan they would effect. For example, for some plans with inpatient and outpatient coverage, the deductibles may only apply to inpatient medical expenses while the co-insurance may only apply to outpatient expenses. The clearer you are about your plan, the fewer issues you’ll run into when you use it!
#2 Use direct billing
Spare yourself some stress by using direct billing options that are part of your plan. Some insurance companies may be able to arrange direct billing for both inpatient and outpatient treatments.
Outpatient Direct Billing
Many insurance companies will have a network of healthcare providers they have direct billing arrangements with. One of the best ways to make use of your insurance company’s direct billing network is to pick out a few providers ahead of time – that way, when you need to visit the doctor, you’ll already know where to go. A great idea is to pick a GP near your home, and another near your office, so there’s always a clinic nearby that you’re familiar with.
Inpatient Direct Billing
In some cases, your health insurance company can arrange to pay hospitals directly. This can be a huge blessing when it comes to costlier treatments such as surgeries, as you won’t need to pay a large amount and then wait to be reimbursed. This is called a letter of guarantee (LOG), where the insurer and the healthcare provider agree on the treatment and its cost. As frustrating as this might feel during major health scares because it can take a few days to put in place, it’s an important part of making sure there won’t be any unwelcome surprise expenses.
#3 Set up an online account
Many health insurance companies are making things easier by offering online customer portals or smartphone apps for their services. Many are focused on making submitting and tracking your claims an easier experience. In most cases, your medical insurance provider will provide you with the information for creating your account when your plan is issued. It’s a good idea to set up your online account or phone app as soon as possible so it’s ready to use when you need it; this will save you the trouble of searching through old emails or requesting a new password at a later time.
#4 Don’t forget your forms!
In some cases, your insurance provider may require your doctor to fill out a form in order to get a referral to a specialist or to submit a claim for reimbursement. Nobody wants to visit the doctor a second time just to fill out a form, or even worse, get charged for a second appointment! A way to save yourself some trouble down the road is to print out a few claims forms ahead of time. Keep them around the house or office so if you need to go to the doctor urgently, you can just grab one to take with you on your way out.
As simple as these suggestions sound, they can go a long way towards making your experience more hassle-free.
Read more about keeping yourself covered in our Health and Fitness section: