Making a Health Insurance Claim
Different health insurance companies have slightly different ways in which they deal with claims so it is important to find out ahead of time how your company deals with claims.
A lot will depend on the type of health cover policy that you have: whether its a moratorium or fully underwritten policy. The most important advice is unless you are prepared to be out of pocket do not agree to any treatment or consultation that has not been agreed by your insurance company.
1. Visit your GP
This should alsways be your first port of call. If your GP agrees that you need to be refered for treatment or further investigation then you need to inform them that you are making an insurance claim and give them the details of the company that you are with.
In order to make a claim you will need details of your condition and probable diagnosis and the treatment that has been suggested. You will need the details of the consultant/hospital that you would like to have treatment with.
2. Contact your medical insurance company
Some companies provide an online claims method as well as a telephone number for you to ring.
You will be asked about the details of your condition and in some cases you will be informed that the insuerer will need to contact your GP to get more details about your health status. When you sign a private health insurance policy you must make sure that you have answered everything truthfully - any differences in what you have said and what the GP reveals about your records may invalidate your claim at this stage.
3 Confirmation of claim
You health insurance company will confirm whether you are covered for treatment/consultation under your policy. Companies vary in the length of time that they take to do this. Pruhealth issue an authorisation code which you need in order to have your bills paid efficiently.
4 Make an appointment
Once your medical insurance company have agreed to pay for a claim you can book an appointment to begin treatment. You will need to take your insurance details with you when you go.
5 Paying the Bill
Companies vary in how bills are settled. In most cases bills are sent directly to health insurance companies who then settle up with the health care providers. In some cases you pay the bill and your insurance company pays you back. With some policies, for example with Freedom Healthnet Ltd, the rules are very different. Freedom pay you the cash and then you pay the health provider directly.
A lot will depend on the type of health cover policy that you have: whether its a moratorium or fully underwritten policy. The most important advice is unless you are prepared to be out of pocket do not agree to any treatment or consultation that has not been agreed by your insurance company.
1. Visit your GP
This should alsways be your first port of call. If your GP agrees that you need to be refered for treatment or further investigation then you need to inform them that you are making an insurance claim and give them the details of the company that you are with.
In order to make a claim you will need details of your condition and probable diagnosis and the treatment that has been suggested. You will need the details of the consultant/hospital that you would like to have treatment with.
2. Contact your medical insurance company
Some companies provide an online claims method as well as a telephone number for you to ring.
You will be asked about the details of your condition and in some cases you will be informed that the insuerer will need to contact your GP to get more details about your health status. When you sign a private health insurance policy you must make sure that you have answered everything truthfully - any differences in what you have said and what the GP reveals about your records may invalidate your claim at this stage.
3 Confirmation of claim
You health insurance company will confirm whether you are covered for treatment/consultation under your policy. Companies vary in the length of time that they take to do this. Pruhealth issue an authorisation code which you need in order to have your bills paid efficiently.
4 Make an appointment
Once your medical insurance company have agreed to pay for a claim you can book an appointment to begin treatment. You will need to take your insurance details with you when you go.
5 Paying the Bill
Companies vary in how bills are settled. In most cases bills are sent directly to health insurance companies who then settle up with the health care providers. In some cases you pay the bill and your insurance company pays you back. With some policies, for example with Freedom Healthnet Ltd, the rules are very different. Freedom pay you the cash and then you pay the health provider directly.
Labels: Freedom Healthnet, health cover, health insurance, medical insurance, private health care
posted by Insurance News at
8:29 AM
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