Tips for Dealing with Insurance Companies

Read your policy information carefully.

Find out co-payments and whether certain specialties are Out Patient vs Office Visit
Get referrals from your primary care doctor to specialists

Find out if you qualify for additional insurance based on your child’s diagnosis (Title 19, etc). Start the paperwork early. Wait times can be a year or longer.

If you qualify for state or federal aid, be sure that your child doesn’t have money in their name (savings account, 529 plan) that exceeds limits that may disqualify them later.

Log every call to insurance companies in a notebook. Record the time, date, the name, extension of the person you talked to and your questions and the answers.

If seeing a specialist be sure when they order the test that they will send a letter to Insurance with reasoning as some tests are easily denied but these letters can help the approval process.

If a claim is denied, call your doctor’s office and ask to speak to their insurance specialist. They may be able to code the medical appointment information differently so that it can be accepted. Or they can help you get a letter from your doctor explaining why the test/treatment was medically necessary and in their financial best interest.

Ask a hospital social worker for help. They are experienced. Even if your insurance company is cooperative, let the social worker deal with insurance matters so you can focus on your child.

Enlist the help of a business office person if your child is treated at a clinic. They deal with insurance companies daily and have a vested interest in getting paid.

Contact Iowa Insurance Division if you need help filing a complaint. http://www.iid.state.ia.us/