How to Negotiate Benefits With Health Insurance Companies

When customers are dissatisfied with the availability of benefits from their health insurance company, they need to be organized, knowledgeable about their plan and willing to ask for assistance if they want to improve their coverage. According to Richard Coorsh, the spokesperson for America's Health Insurance Plans, health insurers exist in a competitive marketplace and consequently "they have to be as responsive as possible to their customers." The most active and engaged customers have the best chance of negotiating more benefits.

Instructions

• 1

  Research the number of specialists in your plan's network of providers if you belong to an employer-sponsored health plan. Inform your employer if there are any gaps in the expertise available or if there is any difficulty finding acceptance as a new patient. In these cases your employer may be able to negotiate for out-of-network benefits.

• 2

  Contact your insurance company before you receive treatment and confirm that your upcoming treatment will be covered. When you call, write down the name of the representative you speak with as well as the date, time and subject of the conversation. These notes will make it easier for you to negotiate with the company if a problem with those benefits arises later.

• 3

  Look up the insurance company's appeal policy and send in the appropriate paperwork for an appeal if your health insurance company denies you benefits that you believe you deserve. Most insurance companies allow customers to appeal their decisions within a limited time frame. If your appeal is denied, contact either the U.S. Department Of Labor or your state's insurance department and enlist the government's assistance in your negotiations.

• 4

  Contact an attorney specializing in health care issues, a health care advocate or a representative of the insurance company's billing department if the health insurance company denies your claim. These professionals know the proper paperwork to file when negotiating for more benefits. Visit the Health Assistance Partnership website to find your state's insurance ombudsman's office, which helps consumers, seniors and the disabled negotiate the same paperwork.