Your physician or other health care provider may file a claim for you. However, if they will not file the claim, you should follow these basic steps: - Review your insurance policy or benefits booklet. There will likely be instructions on how to file a claim. Follow the instructions carefully.
- Obtain a claim form from your managed care organization or insurance company. Complete the form as instructed.
- Obtain a statement from your health care provider to submit with the claim form. There are certain things that must be on the statement. These will likely be listed in your policy booklet.
- Use this letter as a cover letter to accompany the claim form and statement.
- Submit the claim as soon as possible after you receive services. Your provider may have required that you pay the bill or may bill you for the services if they do not receive payment from your insurance by a certain date. The sooner you submit the bill, the better. There also may be a time limit in your policy.
- Keep a copy of the materials that you submit.
- If you haven't heard in a reasonable time, contact the managed care organization or insurance company about the status of the claim.
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