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How to File a Health Claim

If you get sick or have an accident, then it’s finally time to ask for assistance from your health insurance company. It’s important to file your claim the right way so that you can get your benefits quickly.

document for filing insurance claim — *Make sure you have the right document. It doesn’t help anyone if you turn in the wrong page.*

However, be aware that insurers have around 30 to 45 days to process and pay your claim. Filing as soon as possible makes it easier for everyone involved.

Prepare to File

After you’ve made sure you have no exclusions and the claim is within your rights to file, then you can start the process. You don’t want to file and then get an unexpected bill.

Begin by gathering all the relevant documents to your claim, i.e. itemized receipts from your physician’s office. While going in person might take more time, you can get your receipt printed out and ready that day.

These receipts are necessary for your health claim as they provide an easily-read document for your carrier to review every medical expense you incurred during recovery. Make sure these include details like medications you were prescribed during treatment. All of these together will be used by the company to help cover these expenses.

Acquire a Claim Form

Everyone’s insurance company will have a different route to giving a form. The company’s website might even have resources to aid you online. The site can either give you the option to print out a form to fill out at home, or provide you an online version right on their website.

If you get confused during this process, it’s helpful to contact your carrier directly as they’ll have the exact information you need to fill out the form completely. Also of note is that your claim form itself, and the pertaining pages, will most likely have instructions to assist you in completing it fully.

phone for calling to file a health claim — *If you have any questions, call! That’s why specialists are around.*

Important Note: Make copies of this form after you fill it out. If you complete it online, after it’s finished, you should be given the option to download it. Keeping one copy of it yourself protects you in case you need the document in the future. Mistakes can happen, and filing a health claim is one place you don’t want mistakes. Additionally, this form can be useful come tax season.

Submit a Correct Form

There’s one tried and true way to submit a form with the least margin of error. If you want to do this successfully, follow these steps:

Review the information on your form to make sure it’s correct
Call your carrier and ask for assistance in checking your form
Ask for the address to send the claim form or if they prefer to receive the form on their website
After you’ve reviewed, ask if there is anything missing or any final information that is needed before submitting

Once you’ve done this, you can rest assured that you’ve done everything in your power to file a health claim the right way. It’s been checked, reviewed, and approved by your carrier even before sending it. After the process is done and you’ve submitted your form, one last thing you can do for peace of mind is to call or message them to ask for a date when you’ll receive the benefits. After that, set a reminder to follow-up on that date. You should be all set.

How to Understand Your Insurance Contract

Insurance is a huge part of our daily lives, and when you get a new plan you are flooded with forms and contracts. But do you really know what all the forms are and what they mean? One form, the most important form is your insurance contract. This is an important piece to be familiar with because it’s the main document you reference whenever your policy is brought up. It’s the main source of information describing your obligations and your insurance provider’s.

insurance contract with someone signing it — *Make sure you’ve read everything thoroughly. You don’t want any surprise fees down the line.*

It doesn’t take long to understand this document. We’ll get you up to speed in no time at all.

Know Your Terms

Probably the quickest way to lose someone is to speak in insurance lingo. For someone outside the industry, the lingo can get confusing. Here is a general list of broad insurance terms to get you on the same page:

Beneficiary– a person named in a policy that receives the benefits
Policy Owner or Holder– person who holds the plan
Premium– the amount paid to the insurance company to keep the policy valid
Deductible– the amount you pay out-of-pocket every year before the insurance company begins assisting
Carrier– the insurance company providing your policy
Claim– a formal request for benefits by the insured to the carrier

Everyone’s contract will be a little different, depending on the policy type. Your document should have a list of definitions in it describing what they mean.

Declarations Page

The first step anyone will tell you is to locate the declarations page and read that first. Fortunately, it comes before anything else in the insurance contract and has an overview of both the policy and you as the insured. If you’re looking for specifics, on the declarations page, you’ll find:

Who or what is insured
How long the policy will provide coverage
The deductible
The plan’s dollar limits
Your expected payment (premium)
When your payments are due

If you’re looking for answers, the declarations page is the place most likely to have them. General policy and payment details are contained therein and should be formatted to be easily read.

glasses sitting on a book for insurance contracts — *If you’re not sure about something, look it up. You don’t want to misunderstand an important term.*

Insuring Agreement

This is the meat of your contract as it covers everything the carrier will be responsible for. After you’ve familiarized yourself with the terms and oriented yourself with the declarations page, this portion will give you the in-depth look at what benefits you’ll receive from your policy.

There are two distinct types of insuring agreements that you should be aware of:

Open Perils Coverage– Previously known as “All Risk” the name was changed in the industry recently to clarify that it does not actually protect from “all” risks. This plan covers everything except for exclusions named in the contract.
Named Perils Coverage– This policy type is much more specific and details each loss that the carrier will cover, rather than state only exclusions.

You’ll find both policy types outlined considerably in this section as the carrier wishes to keep everything as clear as possible. Coverage definitions are specific for a reason.

Exclusions & Modifications

These are grouped together as the side-dishes if we’re sticking with the food metaphor. Exclusions are detailed examples of what the carrier will not provide coverage for in the policy while modifications (or endorsements) are the alterations made to the original contract. Here are examples of both exclusions and modifications:

Exclusions:

Theft exclusion
Freezing pipes and systems in a vacant property
Settling, wearing of property
Government actions

Modifications:

Additional storm coverage
Home business coverage
Detailed property item coverage (valuables or otherwise)

Conditions

Lastly, you should review the requirements to maintain your coverage. After taking note of everything in your contract, you don’t want to miss out on benefits because you failed to meet the conditions outlined in the document.

man in pink suit looking at insurance contact — *There are professionals in the industry waiting for your calls. Don’t hesitate to ask for help.*

These are actions you as the insured must take to keep your policy valid. For example, one popular condition added to most contracts involving property is to notify the police once the damage is done. If you haven’t filed a police report, or have the report handy for the insurance company, then your carrier can consider you breaching their contract, and will withhold the benefits you need to get your home or business up and running again.

Once you have all these checked off your list, you should have a well-rounded idea of what your policy will cover and how to keep it. Important details from the contract should be noted separately or highlighted on your copy(like premiums and exclusions) so that you can easily reference them later.

As always, EZ.Insure is around to assist with your insurance needs. Your agent will answer any questions you have, compare different plans for you, and even sign you up when you’re ready, free of charge and without having to worry about being hounded by endless calls. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing [email protected], or calling 888-350-1890. EZ.Insure makes the entire process easy, and quick.

How to Negotiate With Your Insurance Agent

So, you’ve successfully got your business up and running, you got all of your finances in check, and now you’ve searched for a quote with EZ.Insure’s quote engine to find a new policy (group health or commercial). So–now what?

Well, you definitely can’t sit back and relax just yet. Now, it’s time for you to put on your Negotiator hat so you can get the best rates for your company. We’ve got a handy list here for exactly what you need to do (and why).

Be Hungry

woman meeting with insurance agent — *Like most conversation skills, this takes practice. Try talking with a friend to hone your edge.*

And we don’t mean for a burger.

Be hungry for answers and for results. When you take a call or travel for an office visit, bring a notepad or use a device to record important questions beforehand. Often times, people forget (or are reluctant to speak about) potential savings unless asked first. These questions involve things like:

Are there any discounts?
What are all the rates I qualify for?
Why should I purchase from you?

Come prepared to every meeting with a desire to better your business. If you come with a fighting attitude, the rest will fall into place. People respect you more when they see the conviction you have for your plans. It makes you look more attentive, reliable, and attractive when you arrive ready to resolve things.

Be Informed

Don’t just take everything at face value. Of course, insurance agents are the industry experts, after all, they do have to pass an intense exam before they get their license. But, don’t forget that they’re human too. Sometimes, it’s impossible to know absolutely everything.

People can overlook information as well. Do some digging on your own (nothing too deep, just enough to be aware of things like fees). This way, you’ll be aware of insurance rates and what the market says about them. You’ll also find it easier to talk about your terms if you know the lingo. Certain words like “premium” can mean different things in normal conversation.

close up of a suit for an insurance agent — *A bonus tip: dress to impress. You’ll feel better and look more confident.*

Be Open

If you’re shopping around for a policy, do just that–shop around. Don’t just take the first offer handed to you. If you look around at a bunch of different plans (an easy tool with EZ.Insure) then you’ll have a better idea of what you’re buying comparatively. Your rates aren’t concrete, so you have some wiggle room with negotiating a better price if you can cite another source.

Remember, even if you’ve found the perfect policy and you love your agent, you can check back regularly, about every six months. Check on your insurance package to see when it’s updated and make a habit of asking the above questions. Circumstances change in the insurance world regularly, and you don’t want to miss out on a surprise cost-saving option that just came up!

EZ.Insure was born to help you get to this point. Your agent will answer any questions you have, compare different plans for you, and even sign you up when you’re ready, free of charge and without having to worry about being hounded by endless calls. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing [email protected], or calling 888-350-1890. EZ.Insure makes the entire process easy, and quick.

How to Choose a New Primary Care Physician (PCP)

Your doctor is one of the most important people in your life, so choosing the right primary care physician (PCP) is a big decision. The doctor, and by extension the clinic they work in, are both going to be heavily relied upon when you’re sick. The last place you want to go is somewhere you’re not comfortable with.

Remember, this is the person you rely on to stay as healthy as possible, and you should make your choice based on a few key steps.

PCP with patient looking at x-rays — *Your PCP is an important partner for taking care of your health.*

Locate the Clinic

The clinic where your doctor works is the easiest way to find and contact them. You can find a list of these online with a quick search and most come with reviews attached, as well as information like address and phone number.

Once you gather a list, you can start narrowing it down. Ask questions like:

Is the office close to where I live and work?
Are the doctors recommended by people I know?
How are the reviews on the website?
Do they accept Medicare Advantage transportation benefits?
Are they in-network?

To make matters easier, some health insurance companies have search engines that give you a list of in-network doctors near you. This can be a big time saver.

After you answer all these questions, you should have about 2-3 doctors that you’re ready to research a little deeper.

Gather Information

Another way to utilize your health insurance company is to see if they have a quality check for the PCPs they list. Alternatively, there are other online resources that list accredited doctors with their awards, acknowledgments, and organizations they are a part of.

PCP and surgeons operating on a patient — *You don’t want to wind up here after neglecting your health. Work with your doctor.*

Once you’re reasonably sure of your decision, it’s time to place a call to the clinic. You don’t want to wait until you’re sick and stressed before you choose a new PCP. This should be done carefully, so you know your choice is accurate.

Make a cold call to the doctor’s office. Doing this is a great tactic that will answer several questions just based on the conversation you have with the staff:

Is the staff friendly and communicative?
Is the clinic taking new patients?
How do they handle prescription refills?
Will they follow-up on your services?

Just a quick conversation can help narrow down what atmospheres are better for you. Remember when you’re choosing a physician, you’re also choosing their staff, meaning the nurses that assist you, the technicians involved, and the receptionist.

PCP holding red stethoscope — *Remember to choose a doctor you trust. The most important part is feeling comfortable talking with them.*

Meet In-Person

The final step before choosing is to meet with the PCP in person. This is going to give you that final comprehensive view of what it’ll be like to interact with them on a regular basis.

One good way to do this is to ask for a physical. A general health look will get you familiar with their facilities and is sometimes covered by your insurance as well. During the exam, you can talk to the doctor and see what their specialties are, what their manner is, and how you feel about including them in your life.

Paying special attention to how they speak to you is important. Some people prefer a friendlier doctor who will chat for a moment and remember personal information while others prefer someone who is all business. Whatever your needs are, this last visit should settle in your mind which doctor is the right choice.

While you don’t have unlimited funds for this search, you should still take your time. Listen to your instincts before you choose a doctor because they’re usually right. Your PCP is someone you need to trust with personal information, and someone who will be knowledgeable about your medical history. Don’t be afraid to start over if you feel like you’ve made a mistake. As long as you’re in-network, you should find someone you’re happy with.

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