Strategies for Managing Your Health Insurance Records
It’s important to have, keep, and manage your health insurance records during your illness. Although it might seem like too much of a burden to take on at this time, perhaps you can call upon a family member, close friend, or trusted bookkeeper to help you.
Regardless of how you handle it, the bottom line is this: Having your records in good order will actually lower your overall stress…and perhaps even return some of the control over your life that cancer seems to have taken away. Where do you start?
Record-keeping is your first step. It’s important for keeping up with payments, maintaining your credit rating, or taking advantage of the deductions available in filing itemized tax returns. The Internal Revenue Service (IRS) can provide information and free publications regarding tax exemptions for cancer treatment expenses. It will even allow you to prepare for a future with little or no ‘cancer debt.’
- Decide who will be the family record-keeper or how the task will be shared
- Seek the help of a relative or friend. This may be especially important for people who are single.
- Set up a file system in a file cabinet, drawer, box, or three-ring notebook
- Make sure all bills and explanations of paid benefits are accurate
- Review bills promptly after receiving them
- Save and file all bills, payment receipts, and canceled checks
- Keep a daily log of events and expenses; a calendar with space for writing will be useful
- Maintain a list of phone numbers for cancer care team members and other contacts
Keep Records of These:
- Medical bills from all healthcare providers
- Claims files
- Reimbursements and explanations of benefits
- Dates, names, and outcomes of contacts made with insurers and others
- Non-reimbursed or outstanding medical costs
- Meals, lodging, and travel expenses, including gas
- Long-distance telephone calls related to medical or other types of care, including psychosocial care
- Admissions, clinic visits, lab work, diagnostic tests, procedures, and treatments
- Drugs give and prescriptions filled
Handling a Claim Denial or Refusal to Cover a Prescribed Service:
It’s not unusual for some claims to be denied or for insurers to say they will not cover a test, procedure, or service that your doctor orders. But we have a sure-fire way of limiting these occurrences: OHC Financial Navigators are experts in assisting you with your financial needs. We encourage you to make an appointment to discuss your situation or need.
However, if you do get a denial of coverage from your insurance, it’s important to have a working relationship with your health insurance plan’s case manager.
Your first step will be to resubmit the claim with a copy of the denial letter. It may be necessary for a patient’s doctor to explain or justify what has been done or is being requested. Sometimes, the test or service will only need to be “coded” differently. If challenging the denial in these ways is not successful, then you may need to:
- Contact OHC or an OHC Financial Navigator for financial assistance
- Postpone payment until the matter is resolved
- Resubmit the claim a third time and request a review
- Ask to speak with a supervisor who may have authority to reverse a decision
- Seek help from the Consumer Affairs division of your state’s Department of Insurance: Contact the Ohio Department of Insurance at 1-800-686-1526. Contact the Kentucky Department of Insurance at 1-800-595-6053. Contact the Indiana Department of Insurance at 1-800-622-4461.
- Consider legal action
The first step is always the hardest. But once your on a proper record-keeping path, you’ll find that organizing your records is energizing. And don’t feel like you’re alone; an OHC Financial Navigator is always here to help.