Cut The Wait: Simple Steps To Speed Up Your Reimbursements

Hospitalisations are mostly cashless, but certain expenses like those incurred 30 days before or after a surgery, are paid on a reimbursement basis. Often, these reimbursements take a long time to get through. While the amount may not be very big, it is still something that your insurance covers. Here is how to speed up the reimbursement process.

Timely Responses Speed Up Reimbursement Processing

Often, delays occur when key documentation is missing, submitted in multiple batches, or erroneously documented. To greatly reduce this, individuals should assemble all necessary items – bills, receipt documentation, investigative reports, discharge summaries, etc. in a single,  organised folder prior to submission.

“This way, there will be less back-and-forth regarding these queries. Some Insurers have mobile applications and/or online dashboards where consumers can submit claim forms, bills, and prescriptions electronically; therefore, there is no mailing delay and acknowledgment will be Immediate,” says Arun Ramamurthy, co-founder, Staywell.Health.

Policyholders should also consistently check their claims for alerts indicating document deficiency and respond accordingly in a timely manner by submitting any required documents. Policyholders should also keep scanned copies of all documentation in order not to lose any paperwork throughout the process.

In addition to keeping accurate documentation, it is important for policyholders to have a thorough understanding of their insurer's timelines, formats, and pre/post-hospitalization timeframes in order to avoid delays due to lack of compliance with filing procedures. “When individuals complete the documentation process accurately and track their claims digitally, the claim reimbursement process will be considerably expedited,” says Ramamurthy.

Agents Help Make Hospital Claims Smoother

When a patient goes to the hospital for their medical procedure(s), having an experienced insurance agent can be beneficial. An experienced agent will serve as an intermediary between the patient, the hospital, and the insurance company. As time-sensitive events occur during the medical treatment process, agents can help by ensuring that the necessary documentation is provided at the beginning of the claim, thereby reducing errors that might otherwise delay the process.

It is common for agents to work with hospital billing departments to obtain accurate discharge summaries, itemised invoices, and pre- and post-hospitalisation documents. “Because agents typically have extensive knowledge of insurance company processes, they may be able to expedite requests and pending authorisations by navigating the appropriate channels,” says Ramamurthy.

By being proactive in following up, they help ensure that authorisation requests and other clarifying issues are processed as soon as possible without becoming lost in backlogs. Insurance agents also assist clients who do not have access to online submission tools. Many clients prefer that someone else handle the submission process, and they request that an agent track and update them on the status of their claim. In the end, while it is the insurance company that makes the final determination regarding a claim, the ongoing assistance and guidance provided by an insurance agent will often result in a significantly faster, less erroneous process.