Health Insurance Reimbursement

Health insurance is one of the most discussed, but least understood topics in the United States.  Insurance coverage is complicated and it is important to have a dedicated and experienced legal professional on your side if you need to fight an insurance company for reimbursement that is owed to you.

When Might My Health Insurance Company Owe Me Money?

Health insurance in the United States is not a simple thing.  There are many types of health insurance plans with different objectives, coverage amounts, deductibles and limitations.  Attorney James Ponton understands the issues surrounding health insurance. Contact him today and let him help you.

An insurance company can owe you money when your health insurance plan covers certain expenses that you have paid for out-of-pocket.  For example, if you broke your arm and incurred a bill for the medical attention you received, then your insurance company may owe you for that expense.

Whether a health insurance company owes you money for your expenses or not depends on the terms of your health insurance plan.  Contact Ponton Law today if you are unsure what your plan covers or if you believe that you have been inappropriately denied reimbursement for medical expenses.

What is a Health Insurance Reimbursement Plan?

Typically, your medical professional (doctor, nurse, hospital, etc.) will bill your insurance company directly for expenses that you have incurred after you have met your deductible.  However, there are certain types of health insurance plans where you are responsible for the initial cash payment for the medical services received.  You are then responsible for submitting those expenses to your health insurance company for reimbursement.

Your health insurance company is supposed to review the expenses and then send you a check to cover the costs if the expenses are covered by your plan.  Unfortunately, many insurance companies will try to claim that the expense is not covered by your plan and therefore deny you reimbursement.

Contact us today if you have been denied reimbursement for qualifying medical expenses.  We will work with you to ensure that your insurance provider is held responsible and that you receive the compensation that you deserve.

Coming Changes to Health Insurance

The new administration has made it clear that there will be significant changes to the way health insurance is managed in the United States.  These changes will likely impact you and your family.  There are a few things that you can do regardless of these changes to help ensure that you’re being treated fairly by your insurance company.

  • Understand Your Policy. Understanding your health insurance policy – what you are and what you are not entitled to – is critical.  Contact us if you do not understand the terms of your policy.  Staying informed will help you better manage your health and health insurance.
  • Keep Accurate Records. It may seem like your health insurance provider is sending you a never-ending stream of letters and emails.  Typically, those communications that discuss critical changes to your coverage are marked as important.  Create a designated file to keep such communications -- we may need them if you are being denied reimbursement.
  • Get Documentation. After receiving medical attention, it is important that you obtain any documentation that is available to you.  Medical billing is notoriously unclear but that should not stop you from requesting and receiving a complete and up-to-date bill for any medical services received.

Medical insurance is complicated.  That said, it is important to try to simplify matters as much as possible. Read and understand your policy, keep accurate records, and get all billing documentation.  Paperwork is often what will make or break your case.  Please contact us online or call Ponton Law today at 404-418-8507.

Contacting Ponton Law

Contact Ponton Law today at 404-418-8507 if you have any questions or concerns about your health insurance policy.  Attorney James Ponton is an experienced personal injury attorney and he has dedicated his career to helping the injured.

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