Health Insurance Claims

Health insurance law has taken interesting turns in the past few years. As it stands, every American must have insurance. Unless an individual files an exemption, the government will levy a penalty tax for not having insurance. Whether you have private or public health insurance, the policy remains the same.

In fact, people tend to not think about health insurance until they need it most. Health insurance policies are important for Philadelphians to read. Once you obtain health insurance, make sure you understand everything in your policy. If at any time your health insurance company does not appear to have high standards, you should contact a health insurance claims lawyer immediately.

Freundlich & Littman, LLC are your greater Philadelphia health insurance claims lawyers. If you are in need of a lawyer to fight your health insurance provider, we are here for you.

How Do I File An Insurance Claim?

Health insurance coverage should be automatic. You should take your insurance card to the doctor or pharmacist so that they may process your insurance on the spot. If the insurance does not go through, your next step is to get in touch with your insurance company to check for problems. You pay money each month and deserve the have the fullest protection for your money.

Your next priority is to seek immediate legal advice. A health insurance attorney can speak on your behalf, especially if you are in poor health. Health insurance may be private or public, depending on your situation. The process for Medicare and Medicaid claims are different than private insurance. It is important to understand that aspects like appeal rights and process times are, therefore, different.

No matter the type of health insurance that covers you or your family, your actions should follow the same path. First, contact legal representation and follow their specific guidelines. As a general rule, always keep any paperwork related to your medical insurance claim safe until the claim process finishes or directed otherwise by your health insurance claim lawyer.

After filing a claim with your medical insurance provider, you may receive communication for more information about your medical issue. Prepare yourself for several questions, including requests to see another doctor. Your insurance company may also request proof of medical necessity for your medical claim or a claim to use a brand medication over the generic.

After their investigations into your claim, you may receive an offer to settle. With mounting medical bills, their low offer is tempting. You should know that you have the right to deny the offer. Further, you reserve the right to seek legal advice to discuss other avenues to take. An experienced health insurance claims lawyer can help you to navigate the process from start to finish.

Denied Benefits?

If your insurance company denies your claim, you have options. If a simple phone call to your insurance company does not work, contact your attorney straight away. In fact, you should have your attorney contact your health insurance provider on your behalf. Insurance companies disregard the average policyholder when it seems they lack power. This is where a health insurance claims attorney can make the difference between compensation and medical debt.

When deciding whether to appeal your health insurance denial, do not hesitate to seek outside advice. Contact Freundlich & Littman today to schedule a free consultation.

What Happens With the Claim?

First, your insurance company may call you for an examination under oath. Insurance companies use these legal proceedings to weed out fraud and claims they do not have to legally cover. With this summons, you should know any answers are under the penalty of perjury. To avoid finding yourself in a complicated legal process, it is strongly advised to seek legal representation before the examination under oath.

A second possibility is an outright denial based on unseemly practices. If you have a preexisting condition or an on-going illness, your health insurance provider may reevaluate your policy through medical underwriters. Medical underwriters assigned a value to your policy when you signed up. After you make a health insurance claim, a bad insurance company will assign the case for further evaluation. Changing the terms of the policy after the claim is grounds for a lawsuit.

In either avenue, you will receive either a denial or an offer about your health insurance claim. Again, you have the right to deny or appeal the offer. Contact your health insurance claims attorney as soon as you receive communication.