Whether you’re asking about how much you owe your doctor’s bill or checking to see if a particular treatment or drug is covered, you may have many reasons to call your doctor Health insurance company.
Unfortunately, this can be a frustrating process. According to a recent report from Forrester Research, more than half of consumers are dissatisfied with their experience with a health insurance company over the phone.
While interacting with your insurance company can be overwhelming — especially if you need to discuss a complex or confusing issue — you can make communication as smooth as possible by following these simple tips.
Be sure to prepare for the call ahead of time.
look at yours Insurance document so you know exactly what your plan covers. Have your insurance card and other documents in front of you before calling the insurance company. If you do not have detailed medical bills, ask your doctor for these bills.
“Take the time to write down what you wish to discuss, the answers you want, and what information you are looking for,” says Christian Worstell, a licensed health insurance agent in Raleigh, North Carolina. “Then check each item while you’re having a conversation, so you’re not talking to yourself.”
Don’t call on Monday morning.
Because many medical events occur on weekends, Mondays tend to be the busiest time for insurance call centers, said Brad Cleveland, a customer strategy and management consultant based in Sun Valley, Iowa.
Mornings are also usually the busiest time of the day, Cleveland said. So if you call later in the week to make an appointment, you may get a less tired and more attentive representative.
Take detailed notes during the call.
Write down the time and date of the call, as well as the name and employee identification number of the person you are speaking with. Take note of any action they agree to take and follow up by email or fax, restating the point in writing. Ask for details where possible.
For example, if an insurance company rejects a claim, ask them to share the reason for the rejection and point to the part of your insurance policy that confirms the rejection is legal, says Gail Trauco, an oncology nurse and patient at Senoia. Advocate, GA, who founded Medical Bill 911, an online course dealing with medical bills.
Don’t forget that you are dealing with a person who does their job.
While you may be frustrated by the situation, yelling or losing your temper won’t help you win over your broker.
It’s understandable to feel emotional when you’re dealing with money issues in healthcare. However, if you’re feeling particularly stressed, wait until you’ve calmed down before calling your insurance company.
“You can feel confident when you’re calling on behalf of yourself or a loved one,” says Ailene Gerhardt, a patient advocate in Brookline, Massachusetts. “But don’t be aggressive. Be cooperative.”
Before you upgrade, be sure to give the agent a chance to help you.
While it may be tempting to ask to speak to a manager right away, many front-line service representatives have the authority and expertise to handle the most common calls, Cleveland said. Since managers tend to be skinny and helping many agents, it may be better to work with this representative.
“Agents usually have as much or more experience as their managers,” Cleveland said.
Don’t expect immediate solutions to complex problems.
If you call with a question or issue that may require the opinion of your doctor or insurance professional, you may not get a solution on the first call. Before hanging up, make sure you’ve confirmed your next steps and when you’ll hear back from your insurance company. If you have follow-up questions, please ask for the best phone number.
“Sometimes there will be numbers that are different from the numbers printed on the card, or if it’s very complex, you’ll have a dedicated person or group working with you,” Cleveland said.
Be sure to ask for help if needed.
If you’ve followed the steps above and still don’t feel like you’ve reached an acceptable solution, you may want to bring in a backup. In some cases, your doctor’s office or hospital can support you. Otherwise, you may want to work with a patient advocate through your workplace benefits, or hire one yourself to help you with questions.