How to Fight a Health Insurance Company

Health insurance in the United States can be confusing and frustrating. Working to understand all those codes and the insurance lingo makes you want to accept whatever your insurance company doles out without a fight. But insurance companies make mistakes. Don't let their mistakes turn into thousands of dollars out of your pocket. Fight your insurance company for what you're due.

Instructions

• 1

  Save all explanation of benefits (EOB) from your insurance company. Only discard them after you are satisfied with the benefit payments. Save payment paperwork from your doctors and hospitals, also. If you do have to fight the company, you need to have all the information you need at hand.

• 2

  Understand your policy. Don't assume you have maternity coverage; either you do or you don't. If the language in your policy is too difficult to understand, call the customer service number on your insurance card. Prepare to be on hold for a while, but don't hang up until you get your questions answered.

• 3

  Organize all your paperwork in a binder if you find you will have to fight your insurance company.

• 4

  Record all details. Once you begin your fight, keep records of names, dates and who said what. Your insurance company keeps a record of every communication with you, and you need to do the same. Always get the name of the insurance company employee you contact.

• 5

  Ask your doctor's office or the hospital to help, but don't make it their problem. Many people don't realize that health care providers are not required to file insurance. They actually do it as a courtesy to their patients. If your insurance won't pay, don't expect your doctor's office to fight it out for you. You, as the patient, agreed to be ultimately responsible for the bill when you received services.

• 6

  Request a formal review from your insurance company if you can't get satisfaction about payments. But don't wait too long. Many insurance companies have time limits on appeals, some as short as three months.

• 7

  Contact your state's insurance commissioner if all else fails. He will check into your appeal and advocate for you if it appears you were unfairly treated by your insurance company.