The Six Step Approach To Dealing With Health Insurance Claims

Part 1: The Basic Tools, Chapter 3: Developing a Systematic Approach to Dealing with Health Insurance Page 2

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THE SIX STEP APPROACH TO DEALING WITH HEALTH INSURANCE CLAIMS

Developing a systematic approach to dealing with health in surance claims involves six steps

1. setting up an information file;
2. using the predetermination of benefits process;
3. establishing an efficient claim-filing system;
4. setting up a record keeping system;
5. developing a method for filing claim appeals with insurers;
6. establishing a system for requesting help from government agencies or private organizations.

STEP ONE: SETTING UP AN INFORMATION FILE

Setting up an information file involves writing down questions about your current health insurance policy and then recording the answers to those questions. There are a number of questions and answers that should be included in any infor mation file (See Table 8).

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