Arguing with insurance companies is often frustrating, time consuming, and draining. It is also worth it. My family and I have saved hundreds if not thousands of dollars over the years by checking over our medical bills and arguing when insurance denies or does not pay their correct share.
Step 1: Prepare
-Use headphones and plan something else productive to do while you are on hold. I like to clean, that way I have something visual to show for my efforts like a clean kitchen and bathroom.
-Do not have any expectations of how long you will be on hold.
Step 2: Be organized
-Track each conversation. Yes, it might take more than one call to get your issue resolved. Have a note book page or an excel sheet ready and record the date and time, who you spoke with, and what they told you.
-Keep a medical system and save your receipts. You can use a binder or if you use an app for budgeting, you can track medical bills and save pictures of your bills through the app. This is particularly important when it comes to your deductible. If you hit your deductible, it changes what percentage of medical costs the insurance will pay.
-Be familiar with your insurance. Know things like how many visits are covered under your plan, what your copays are, what your deductible and out of pocket max are, and which providers are in network. This information is typically available online and over the phone.
Step 3: Stick to the Facts and Know the Phrases
-It is so easy to spiral. I have become lost in anger over expensive premiums and how much I have to fight to actually use the insurance. It is easy to get off track, but that just wastes more time.
-I aim to be polite, firm, and to the point.
-Request an appeal if you received a medical denial or request a review if you have errors in what your insurance covered. I typically say things like… “My policy states —-. I was denied —-. I would like to request an appeal.” Or “I believe this was denied in error. I do not need prior authorization and yet this was denied because I did not have prior authorization. I request an appeal.”
Step 4: Stay on it
-I am motivated by saving money.
-I am also motivated by ethics. Many people receive denials and/or inaccurate bills. When we don’t fight to pay the right amount, the insurance companies and big medical corporations make more money off of their errors.
-Track when you are supposed to get refunded or receive an adjusted bill. I requested an appeal, won, but they had 30 days to pay my provider. I had to pay my provider when I received the services that my insurance denied. This meant the provider wouldn’t refund me until they received payment from the insurance. Keep a clear record. Get your money!!
Recommended Reading:
For staggering but an informative deep dive into the history and inner workings of US health insurance and healthcare, check out: An American Sickness by Elizabeth Rosenthal