How to Negotiate With a Health Insurance Company

One of the biggest complaints about health insurance is that they don't always pay for what the patient needs. Many patients don't get the recommended treatments because it's not covered by insurance. However, many times it is possible to negotiate with a health insurance company if a treatment or service is necessary.

Instructions

• 1

  File claims promptly and accurately. Often, claims are not paid because all the necessary information is not given. Be sure to double check claim forms before submitting them.

• 2

  Send a denied claim back to the insurance company with a letter stating why the claim should be paid. The attached letter should clarify why the treatment or procedure was necessary.

• 3

  Get the doctor involved. Many times, if a service or treatment is not covered, a doctor can write the insurance company to explain why he believes it is necessary to get the decision overturned.

• 4

  Make sure to talk to someone in a position of authority. Ask specifically for someone who can authorize what is needed. Get their name, position and direct phone number. It is a waste of time to try to negotiate with someone who doesn't have the power to help.

• 5

  Ask that a doctor review the claim. A peer review panel consisting of doctors is usually who reviews appealed claims. However, in order to get this review, the patient must ask. Make sure to be very specific in requesting that another doctor look over the claim.

• 6

  Enlist the help of a professional. Sometimes it is necessary to get someone involved to make sure that the insurance company deals fairly. Many attorneys are out there that can assist patients when dealing with insurance companies.