by Ed Sneneh, Health Insurance Agent in Chicago Illinois

People who file health insurance claims always wonder how to know if their health and medical insurance claims are being dealt with correctly!  The unpleasant fact is that the vast majority of folks don't know how to effectively file and handle health and medical insurance claims, and just take the word of the insurance company.  Most people imagine that health and medical insurance is too complicated to understand and they just accept what benefits are offered to them. Things do not have to be this way.  Comprehending your medical and health insurance benefits is easier than you think.

 InsuranceNavy is a Chicago, Illinois based a leader in the Illinois Health  Insurance, Hospital Insurance and Illinois Major Medical Insurance. The agency represents several health insurance companies in the States of Illinois, and is offering its services through several locations in the area.

For fast and free consultation, quick quotes please call one of our licensed health insurance agents at:

(708) 233-4848
It is a n established fact that all businesses and individuals make mistakes and errors from time to time, and health insurance companies are not any different.  Health insurers do not do it deliberately, but errors happen.  Educating what your benefits are ahead of time will help you and your family to receive all the benefits you are entitled to.

When some one gets medical treatment and the claim has been submitted to the health insurance carrier, the insurer will start processing the claim.  After the claim is processed, the insurance company will send you, the insured or the member, a statement or form which is known as the 'Explanation Of Benefits'.

In fact the terminology used here maybe a little misleading because most of the explanation forms are written in coded.  However, it is easy to find the answer.  If there are codes out to the side of your treatments there will be a code key somewhere on the form telling you what it means.  There are a few other issues that may be a little confusing too.  For instance, many health insurance companies will put the word surgery out beside whatever treatment you had.  This does not always mean real operation.  Your doctors probably have used a tube up in your nose to look at your sinuses at the doctor office and the health insurance carrier may list that as surgery.

More important than the terminology on this form is being sure you received the correct benefits.  If you know your office visit co-pay is $25, then you should not be billed for anything else, unless you really did have some kind of surgical procedure done that is not covered under the co-pay.

Always look at your explanation of benefits and if it says you are responsible for any or all parts of the charges, then be sure and call the customer service number to the insurance company.  Customer service is there to answer any questions you may have about these benefits and even future benefits.

The easiest way to check your medical payments is to keep your benefit booklet available at all times.  When you can refer to your benefits booklet it is easy to see if you are getting the correct benefits.  This is also helpful to have by your side when talking to a customer service representative.
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