Insurance can be confusing. The more medical care you have, the more there is to keep track of. No one plans to be sick, but preparing and having a system in place will help if you do have claims. If you or your family member becomes ill, the number of bills can be extensive. A simple outpatient surgery could easily generate several bills. You can expect bills, at minimum, from the hospital or surgery center, surgeon, pathologist, and anesthesiologist. Organization will allow you to take care of yourself or your family member and not stress about the paperwork. Managing your medical claims can be easy if you do the following:
- Start a file at the beginning of each year to keep all of your health insurance documents in one place.
- As bills come in, avoid paying the bill until you have your Explanation of Benefits (EOB) from your insurance carrier. Many times a doctor or hospital will bill you before the insurance discount is applied. They also do not usually know the exact benefit and will estimate the insurance payment. This oftentimes creates an overpayment on the account. You should never ignore a bill, but be cautious of paying before your insurance which could create more work for you later to recover the overpayment.
- Once you have both the bill and the EOB, you should be able to match them up to figure out exactly what amount is a discount, how much the insurance paid, and any amount that is not covered and why it was not covered.
- If you get a bill and do not get an EOB within 30 days, it is a good idea to contact the doctor or hospital to be sure they properly billed your insurance company. Have a copy of your insurance ID card handy to provide them any information they may need to bill your insurance.
Pekin Insurance® constantly strives to provide our insureds with Beyond the expected® claim service. We want you and your family focused on being healthy. Let us help make the claim process as easy as possible. If you ever have questions on your Pekin Insurance medical insurance, we are just a phone call away! Call 800-371-9622 for assistance on managing your medical claims.
Amy Darling, FLMI, FLHC, ACS, ARA
Director of Life Claims