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How to Make a Health Insurance Claim

Finally, you have the health insurance you need and you have actually been able to visit the doctor or a medical facility to get your medical needs taken care of. It is a big relief to know that you have medical coverage there to back you up, but in order to take advantage of that coverage and get reimbursed for the costs of your medical care you will need to file your health insurance claim. Fortunately, the leading health insurance companies today make it an easy process to file your health insurance claims. Here at California Health Plus we have chosen only the top health insurance companies today for inclusion on our website so that our visitors will know that they are getting not only low cost health insurance but also quality insurance. The companies we recommend include Blue Cross of California, Blue Shield, Health Net, Aetna, and Kaiser Permanente. Each of these companies will have a slightly different process for filing health insurance claims, but the process is probably a great deal more simple than you imagine.


First, you will need to contact your insurance company (most of the time this will be a telephone call, but some companies may allow you to initiate the claims process over the Internet.) Inform your insurance representative that you need to file a claim and request the appropriate paperwork to do so. When you get the paperwork for the claim, you will generally need to provide specific information including the following: Your name, your health insurance policy number, the name of the doctor or facility where you received medical treatment, the date or dates you received medical treatments, and a copy of your doctor or hospital bill. Keep the original copy of any medical paperwork for your own records: The insurance company will accept a copy as long as it is clear and legible.

Mail or fax the heath insurance claim paperwork to your insurance provider as soon as you can: Claims can take some time to process, so the sooner you submit the sooner you will receive your compensation!

If you have submitted a health insurance claim and are wondering about the claim status, contact the health insurance provider to ask for an update on the claim. Some insurance companies, such as Aetna, allow their policy holders to check claim status over the Internet if you would prefer that option.

If your insurance company denies coverage for something that you thought would be covered, contact your insurer to ask exactly why the claim was denied. If the representative cannot give you an adequate explanation and you believe that your claim was incorrectly denied, you can ask to insurance company to review the claim again, or you can ask to file an appeal to the claim decision. When you file an appeal or ask the insurance company to review your claim again, be sure to include all the relevant paperwork once again, and include a complete explanation of why you believe the claim was incorrectly denied. You may also wish to attach a copy of your health insurance policy with any passages that you deem to be applicable highlighted. Claim decisions do get overturned, so never hesitate to ask questions if you feel you've been unjustly denied!

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