Five reasons why health insurance claims are rejected

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Five reasons why health insurance claims are
rejected
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• Your health insurance policy is your security
  blanket in case you or a family member fall ill
  and need hospitalization and treatment.
• It takes care of your expenses, so that you dont
  need to worry about money when youre unwell.
• Health insurance policies come with a lot of
  terms and clauses.
• You need to take time, read and understand all of
  them in order to not be caught off guard in your
  time of need.

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• Imagine being in the hospital, with bills milling
  up and then finding out your insurance provider
  has rejected your claim.
• There can be nothing worse.
• To keep that from happening you need to know your
  health insurance policy in and out.
• But if you dont, here are some common reasons
  why your health insurance policy provider can
  reject your insurance claim.

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Procedures not covered
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• There may be certain treatments and procedures
  that are not covered in your health insurance
  policy.
• Infertility treatments or dental surgeries are
  some of them.
• The procedure you had, may be one of those that
  are not covered.
• You need to study your policy thoroughly to make
  sure it meets all your medical needs.
• If it doesnt, you need to shop for a new one.

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Pre-authorisation required
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• Some procedures like CT scans and MRIs requires
  pre-authorisation to be filled out by your
  doctor.
• If you fail to get this authorisation before
  incurring the expense it gives your policy
  provider the right to reject your claim.

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Claims made during waiting period
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• You can only make a claim on your health
  insurance plan after the waiting period is over.
• The waiting period can range from one to four
  years.
• If your make a claim for treatment for an illness
  during the period, your illness is termed as
  pre-existing illness and your claim stands a
  chance of being rejected.

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Late claims
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• Every Health Insurance Policy provider needs to
  be informed about a hospitalisation, within a
  stipulated time period.
• In case of emergency hospitalisation, the insurer
  needs to be informed within 24 hours and in case
  of planned hospitalisation and treatment the
  insurer should receive intimation weeks in
  advance.
• If you fail to do so, your claim can be rejected.

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Out-of-network provider
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• Every insurer has network of hospitals that they
  operate in.
• While buying a Health Insurance Policy you need
  to find out whether the hospitals that you prefer
  are in that network.
• If you are admitted to a hospital that isnt in
  that network, your claim can get rejected.  

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Thank You