How to Submit a Medical Insurance Claim

Filing a medical insurance claim is a fairly simple procedure that anyone with medical insurance can do. Whether the company will pay the claim and how much they will pay boils down to your plan, the company and its history of paying claims. But simply making the claim is relatively straightforward.

Things You'll Need

• Insurance card or information
• Telephone

Show More

Instructions

Submitting the Claim

• 1

  Typically, the insurance company will provide you with a card proving you are insured with the company. Often, the card will not only list your company and where to call or mail claims but will also list your policy benefits. For example, Coventry lists the plan type--which in most cases will be HMO or PPO--along with the copay amounts for doctor visits, as well as a customer service line and a mailing address for claims. Make sure you have this information--a hospital will usually ask for it unless its a serious emergency.

• 2

  Start by calling the customer service line listed on your card. Another person you could call, if you have private insurance through a carrier like Blue Cross, is your insurance broker who sold you the policy. This is sometimes a preferable way to go because the customer service rep from your broker's office can help deal with the insurance company. If not, you can deal directly with the insurance company's customer service people and they can help you fill out the appropriate forms.

• 3

  Once you have contacted the company and made your claim, things are then in the hands of the insurance company. The company should keep you informed as things move along what the status of the claim is. Some companies, like Aetna, will also let members check the status of claims online.