Being Prepared Will Lead to Productive Phone Calls with Insurance Carriers

Health insurance carriers are not known for having excellent customer service. However when you pick up the phone and get a live person on the other line, there is a good chance you can get something done. Here are a couple tips to help you find success during those tough conversations with insurance carrier’s support teams.

Gather All Necessary Information About Yourself and Your Situation

Gather your paperwork and be prepared as soon as they pick up the phone.  You’ll need your Group Number and Subscriber ID to find your policy details. The billing departments often use a specific billing number rather than the Member ID. Remember, these carriers only have the info you sent them in during your enrollment, so it may help to look at your enrollment paperwork.

It is also important to find the specifics about your situation.  Is there a medication that isn’t being covered?  Get the name of the drug, your dosage, and figure out exactly how much you paid.  The more information you can collect the better you’re phone call will go.

Ask and Understand the Carrier’s Process   

The support team member on the other line often can only handle a certain aspect of your request.  They may need to hear back from underwriting or wait until your request is processed. It is your job to get in the mind of what is happening at the carrier’s end and find the next step of the process. If you listen carefully and offer suggestions, you may find a shortcut. For example you could say, “I actually have that form filled out and signed right now. Do you have an email? Could I email this to you now?”

Follow Up with Another Phone Call 

If you continue to follow up, you’ll continue to find people who can help push your request to the next step.  If you haven’t heard back from your insurance carrier in a week, give them a call and see if you can push it to the next step.

If a carrier has an error on their end, they often will not inform you. Sometimes a request will not be completed and you won’t be given an explanation as to why. Being persistent will get things done. Try again and continue to follow up.

Ask Your Insurance Broker to Call the Carrier for You

My team and I have a lot of experience handling claims with insurance carriers.  We know exactly which buttons to press to solve these tough issues. If your broker isn’t willing to do this for you, I’d be happy to.