Health Insurance Tips and Links
Tips – Dealing with your Insurance Company:
When calling your insurance company, always take notes on phone conversations, esp. date, time, person’s name & direct phone number/ext. number, and record/call# assigned to phone call. Attach to disputed bill and/or EOB (insurance Explanation of Benefits).Ask to talk to a supervisor, if progress is not being made.Consider being assigned a case manager or ombudsman to help deal with pre-approvals or problematic denials – it gives you one consistent contact person.Other options – Have the Human Resources/Personnel Director contact the Insurance Broker through which the medical insurance was purchased to help advocate your case for you or give tips on your appeal.
Links: Insurance Claims Denials & Appeals
Dealing with denied medical insurance claims? Complex Child E-Magazine has a great article "Writing Winning Insurance Appeal Letters" - tips, etc. can be downloaded as pdf file! http://www.articles.complexchild.com/00012.html
”How To Appeal A Health-Claim Denial - a helpful article from ConsumerAffairs.com on an issue too many JM families deal with! http://www.consumeraffairs.com/news04/2010/06/health_claim_denials.html
Patient Advocate Foundation (PAF)
The PAF mission is to provide effective mediation and arbitration services to assist patients w/ chronic or life-threatening illnesses with Medical Debt Crisis, Insurance Access Issues & Job Retention Issues. A good resource! http://www.patientadvocate.org/
For access/approval related to IVIG
IGLiving Magazine is an online & print magazine for the IVIG community – http://www.igliving.com -- Kris McFalls, Patient Advocate
FFF Enterprises – Gammaguard, Gamunex, etc. – Click on “Contact Us” – Call “Reimbursement Advisor” -- http://www.fffenterprises.com/Site/ContactUs.aspx
External Insurance Appeals
Medical Insurance Issues? Appealing Claims? Know the contact information for the Insurance Commissioner's Office for your state - the regulatory office for insurance - and the laws for your state. http://www.naic.org/state_web_map.htm
Kaiser Family Foundation has a dedicated webpage “A Consumer’s Guide to Handling Disputes with Your Employer or Private Insurance – State-by-State External Review Programs”. This is for information about the Appeal Process reaching the external, state level. http://www.kff.org/consumerguide/states.cfm
Other helpful Insurance Links
Connecting Kids to Insurance Coverage -- http://www.insurekidsnow.gov/
“Your Health Plan & HIPPA…Making the Law Work for You” -- it’s more than simply a privacy law -- http://www.dol.gov/ebsa/publications/yhphipaa.html
"Top 10 Ways to Make Your Health Benefits Work for You" -- a helpful link by the Employee Benefits Security Administration of the Dept. of Labor covers HIPAA, COBRA, etc. http://www.dol.gov/ebsa/publications/10working4you.html
Changes in Healthcare Law
Key provisions in health care reform went into effect recently. Do you know how the new laws will impact you & your family? http://www.kaiserhealthnews.org/Stories/2010/September/23/8-changes-health-reform.aspx
If you have a new insurance policy or purchased one on or after 09/23/2010, there are requirements to receive preventive services with no out of pocket costs. Please review the list of covered preventive services
available. http://www.healthcare.gov/law/about/provisions/services/lists.html
Know how Changes in Healthcare law and provisions affect you -- http://www.healthcare.gov/law/introduction/index.html
To enhance the understanding of insurance and healthcare reform changes following the passage of the Patient Protection and Affordable Healthcare Act -- http://insureustoday.org/drupal/PAC/
Help with Medical Bills
Genome.gov has a webpage listing helpful web links for “Assistance with Paying for Medical Care & Procedures”, “Financial Aid for Medical Treatments”, “Assistance for Paying for Medications”, “Assistance for Insurance Premiums”. http://www.genome.gov/11008842
Casey Cares Foundation Financial Aid webpage includes links to helpful resources/tools -- http://www.caseycaresfoundation.org/index.cfm?page=financial-aid
NeedyMeds – NeedyMeds, a non-profit, was founded as a resource of information about patient assistance programs (PAPs) and developed into a database of PAPs, disease-based assistance, gov’t programs & other types of assistance programs. http://www.needymeds.org
Rx Assist - RxAssist offers a comprehensive database of patient assistance programs, as well as practical tools, news, and articles so that health care professionals and patients can find the information they need. http://www.rxassist.org/
