Health is an essential component of a balanced lifestyle. However, illnesses or injuries come one’s way when least expected and it is best to have a back-up plan in the form of national health insurance claim.

Despite getting health insurance coverage, the insurance claim process might seem confusing. As a result, one may not be able to receive all the benefits that the health coverage plan has on offer.

Here are five tips that can help you get health insurance claim without any trouble:

  • Notify the insurance company
  • Collect documents from the hospital
  • Never hide information
  • Notify the insurer if there is a change in health status
  • Submit the claim on time

Each of these points has been discussed in detail in the following sections.

Notify the Insurance Company

Regardless of whether it is an emergency or a routine medical procedure, one must notify the insurance company at the earliest. Always keep in mind that the earlier you do so, the better and it is acceptable if someone notifies the insurance company on behalf of the policyholder is one is unable to do so.

If the policyholder fails to notify the insurance company within a stipulated time agreed upon by both parties then the insurance company need to settle the claim. For this reason, it is important to notify the insurer and this is the first way that one can ensure that one’s national health insurance claim will be settled.

Also, before taking up a medical insurance policy always read the policy document thoroughly before signing the contract. This way, the policyholder will be aware of the provisions in the policy and at the time of filing a national health insurance claim there won’t be any trouble.

Collect Documents from the Hospital

Several national health insurance claim plans are rejected due to the lack of documentation. For this reason, one must keep track of all the documents and bills during the course of hospitalization as it has to be submitted along with the claim.

Without proof of payment, in the form of bills and tests ordered, the insurance company is well within its rights to reject a claim on the bases of lack of documents provided. Moreover, the way to avoid one’s claim from rejection is to meticulously document all the receipts, reports and keep them safe.

There might be instances when the insurance company may request for additional reports or details from the doctor to ascertain whether a particular procedure was required or not. It is essential that any additional information is shared with the insurance company without delay that will help speed up the entire process.

Never Hide Information

Honesty is important to sustain long and fruitful relationships and hence one must never hide information from the insurance company. If the insurance company does come to know that a policyholder is withholding information then it is something that is a cause for concern and the insurer may reject one’s claim.

Therefore, always come clean with the insurance company and even seemingly unimportant information may be important. If in doubt, always check with one’s insurance agent or the insurance company to be on the safe side.

Furthermore, if one keeps a channel of communication open with the insurer then there is less room for misunderstandings and the claim can be approved with all the requisite details at the earliest.

Notify the Insurer about Changes in Health Status

It is essential that one must notify the insurance company if there is a change in one’s health status. For instance, if one is diabetic then this qualifies as a change in health status and must be reported to the insurance company at the earliest.

This is important information since coverage plans have certain exclusions and given the change in health status would mean that the policy has to be reassessed. However, not informing the insurer is a breach of contract and hence both parties must work together to make things work.

So, if one intends to get one’s claim settled quickly then all the paperwork and the policy must be up to date. Otherwise, there will be delays or even reject the national health insurance claim filed.

Submit the Claim on Time

Another simple yet important step that must be followed is to submit the claim within the stipulated timeframe. This is one of the reasons why national health insurance claim gets rejected and as a result one has to pay for these medical expenses out of pocket.

Furthermore, it will be helpful to organize all the documents related to the claim to be filed so that the information is shared with the insurer in a systematic manner. Also, it will help reduce the likelihood of rejection.

These are a few ways in which one can ensure that a health insurance claim will be approved. It is not rocket science but requires one to be organized and stick to the timelines provided by the insurance company and then one is good to go.

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