Helpful insurance terms
Deductible: the dollar amount you are responsible for paying before your insurance company starts to pay
Co-pay: a set dollar amount that is your responsibility per session
Co-insurance: a percentage of the amount charged for each session that is your responsibility.
Communicating with your Insurance Company
Call the 800 number on your insurance card and ask for Customer Service or Claims. Have your explanation of benefits in front of you when you call. Speak courteously and confidently, you have the right to be treated respectfully and have your questions answered. Write down the names of each person you speak with. Repeat back answers to confirm the information is correct. Take notes, including direct quotes. If your questions are not answered to your satisfaction, ask to speak to a supervisor. Inform our office of this information, as this will assist us in processing your claim more quickly.
If your insurance company requests information
It is important that you promptly respond to all requests for information (questionnaires) you receive from your insurance company. Failure to do so may result in your insurance company refusing to pay your claim, making you responsible for the full amount.
If you are unhappy with the assistance provided by your insurance company
Communicate your concerns to your employer’s Human Resource Department. Ask them to contact the insurance company on your behalf. Communication between your employer and the insurance ensures you the receive all entitled benefits. You may also file a grievance with the Office of the Commissioner of Insurance at 608.266.3585.