I'm having a problem with my health insurance carrierThey mail forms to me but I never get themAddress correct

Question

The Health Insurance company tells me to fill out a coordination of benefits form that they mail to me on every claim. But I never get them and they have my correct address. They say go online and fill this form out. I do that and they still never pay my claims. I call them several times and each time they state they will issue a check to cover the medical procedures that have been billed. But they never pay. I feel they are giving me the run around. What options do I have to get them to pay. I know other are having this same problem. Could a class action law suit be filled against this company for not paying their claims.

Answer 1

You mentioned a “coordination of benefits.” Do you know what that means? In some cases, a coordination of benefits refers to people who are covered under more than one insurance policy – married couples who both have insurance through their place of employment, for example. When this occurs, each insurance company decides what they will pay for.

Also, have they actually denied your claim? If so, your insurer is required to tell you why in writing. If you have been denied, then you appeal your claim through your insurance company. If that doesn’t work, then you might want to (links are all in the “Sources” section):

·Talk to your doctor again and see if there is anything he/she can do. Sometimes simply recoding a procedure and then resubmitting a claim will do the trick.
·Get a lawyer
·Contact your state insurance department
·If you have insurance through work, contact the Employee Benefits Security Administration
·Talk with local health insurance agents and get new health insurance.

Take care,
Barnes@MostChoice

Answer 2

The COB information they seek should only be updated (by most contracts) once a year. Sometimes it does occur more if a dr/provider indicate other insurance. If you a single policy holder (no spouse or dependents) then typically they do not ask. If through an employer, go through HR or your Group Admin if your insurance company is not providing answers. The insurance companies have guidelines set by the Department of Insurance based on each state and Legally have to make a decision on a claim w/in a certain time frame. Also with any reviews. You could always try to speak to a supervisor at the insurance company as well. Another option is appeal the denials.

Answer 3

If you are a citizen in the United States, the state in which you reside has an Insurance Department. The Insurance Department should have a web site. Do a search to find out what you have to do to file a complaint. It is the responsibility of the Ins Dept to handle problems like this.
If your state does not have a separate department for this, contact your state's Attorney General.

Answer 4

Go to firstgov.gov the Federal main portal. Then go to your state and look up the location for Employees Benefits Security Administration. Call them.

Answer 5

are you able to be lined on your husband's coverage at artwork. If no longer verify to ascertain if the you qualify for any state courses inclusive of coverage at a discounted cost. if no longer then verify for health coverage courses used by utilizing those who're self employed.