Medical review companies role in your insurance claims - your health your coverage your guarantee

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A medical review company supplies more than a second opinion. The unbiased nature of a medical review company is critical not only to the bottom dollar, but to the final result. Too often, patients think they are just numbers in a file or bits of information in a computer program. The maligned image of an insurance company’s automatic denial of claims without really understanding the patient’s need contributes consumer dissatisfaction and frustration.

What Does It Have to Do With You?

Patients are people and when they need healthcare, they don’t want to read the fine print or a medical dictionary, they just want their claims covered. Most often, it’s unlikely they would realize that their insurance claim went through an Insurance Review Organization’s medical insurance review process. In fact, they probably just fill out the forms, hand a receptionist their insurance card and sign on the necessary release forms.

One of the most common complaints about needing healthcare is the cost followed closely by the complications of paperwork generated through authorization forms, claim forms and more. An insurance review organization is an intermediary company that insurance companies may outsource their claims to in order to determine with medical and insurance coverage accuracy the validity of a claim filed by someone insured by their company.

Your Health Matters

Insurance companies who deny a claim are often portrayed as heartless or more interested in the bottom dollar than they are about showing compassion. This perception is only augmented when an insurance company rejects a claim for anecdotal evidence. When a claim goes through a medical review company’s insurance review process – it will not be rejected or denied based on anecdotal evidence.

For example, a patient suffers from shoulder, back and neck pain as well as bra strap grooving and eczema. Her medical history indicates years of chiropractic treatment as well as advice for non-steroidal anti-inflammatory drugs (i. e. Tylenol, Advil) and worn specialized support bras to support a 34DD frame and all of it to no success. Excessively large breasts can cause many of the symptoms the woman’s medical history indicated.

The doctor recommended a breast reduction procedure to alleviate the problem and the symptoms.

Your Coverage Matters

When the claim is submitted to the insurance company, the policy may not cover elective cosmetic procedures. Many policies do not. Claim managers lacking medical expertise will often compare a procedure request against a list of approved procedures. If cosmetic procedures are not covered, it is likely the claim will be denied. The patient is left either choosing to pay for the procedure out of pocket or continuing to suffer.

If the claim is submitted to a third party intermediary such as a medical review company, the answer will be different. The medical review company has access to a large number of medical specialist and insurance experts. The medical specialists will review the patient’s medical history and the doctor’s recommendations. When her file is reviewed, the third-party specialist will take into account the history of shoulder, neck and back pain. They will note the visits to a chiropractor and other pertinent symptoms.

If the medical specialist agrees with the patient’s physician that she is suffering from Macromastia (excessively large breasts), then he or she will understand that the cosmetic surgery of breast reduction provides the patient with the best option for the patient’s relief.

Confidence Matters

The review process may be transparent to patients whose insurance company uses a medical review company; but the effect is profound. Their coverage premiums will likely be lower. Their medical needs will be addressed. They will not see their healthcare costs rise due to the underwriting of unnecessary procedures. When it comes right down to it, a medical review company gives patients confidence that both their medical and insurance needs will be met. They won’t have to suffer misery unnecessarily nor face collections over mounting debt.

Reliable life insurance company which companies are the best

The life insurance industry is a carefully regulated industry. Every state has its own insurance department to monitor the activity of insurers. You very rarely hear of life insurance companies that dissolve because of financial problems. Insurance companies have to prove financial strength to operate in most states. Insurance commissioners have the authority to approve or deny rate changes. There are consumer guides that are available to help you compare companies. The AM Best Company is the most reliable resource in the industry. You can visit AM Best online and you will find all the information that you need about financial strength and product information.

Life insurance companies distribute their products many different ways. The agent distribution system has been around a long time. The life insurance professional is a valuable resource for people that want an on going relationship with an agent. A lot of folks want the personal service that only an agent can provide. Life insurance can also be purchased through the mail. There are a number of companies that use direct mail as their distribution system.

Insurance companies are also offering life insurance online. This is convenient for most folks that love to use their computer to make purchases. The online purchase can also lead you to an agent. That can give you the best of both worlds. You can begin the process by getting a quote online and finish the purchase with an agent from a company of your choice. The company best for you would be the combination of the financial strength and whether or not you prefer to be serviced by an agent.

There is one more factor when selecting an insurance company. Do you want to purchase insurance from a stock company or a mutual company? Stock companies are owned by the stock holders while the mutual companies are technically owned by the policy holders. Mutual companies pay dividends. Stock companies do not. Compare the rates of a stock company with a mutual company first and then compare the rates of stock companies with stock companies and mutual companies with mutual companies.

Everything is taken care of with consumer health insurance

Have you ever wondered what would happen if all of a sudden there is a health problem in the family and you have no resources to tackle that situation? Well this can only be described as carelessness. You ought to keep yourself prepared for mishaps in life and the best way to go for that is through consumer health insurance.

Mishaps and accidents do not have harbingers attached to them that is why it is important to have health insurance in addition there is also the old saying of precaution is better than cure which is also true in this regard.

The purpose of the consumer health insurance is to make a person feel secure about his future so that the life can be enjoyed to its fullest. That is why various consumer health insurance policies have been made available for the people who want to get insured.

These policies include:

Fee for service - is a traditional type of health insurance scheme where the agency pays a percentage of the costs and you pay the remaining. Premiums are generally higher in this scenario.

Managed care plans – other incarnations for this are health maintenance organizations (HMO’s), preferred provider organizations (PPO’s) or primary care provider (PCP) in this you pay monthly premiums and when you use the policy you only need to pay a small amount called co pay. The amount is Ј10 to Ј15.

COBRA - this is an option offered by the federal government of USA it stands for consolidated omnibus reconciliation act of 1985. With this you can also insure for other aspects that you want to insure.

People with health problems or any other pre existing conditions in usual scenario will find it difficult to get these consumer health insurances. However they can go in for other offerings like temporary coverage, open enrollment or HIPAA.

To get consumer health insurance the best way to go for that is through a broker. A broker can help you in many matters apart from getting you a deal well suited to you.

• A broker can help you in making decision on which scheme to choose a guaranteed renewable or a non cancelable one.

• A broker can answer your queries that you may have regarding the consumer health insurance.

• A broker can help you get a scheme where you can reduce your monthly premiums to as low as 50% of the earlier amounts.

• A broker will provide you guidance at every step of the process of consumer health insurance.

That is why you should go in for consumer health insurance through a broker.

Mean can be any of many but the purpose is one and that is consumer health insurance. No matter what the profile of a person is safety comes first and for that the most appropriate way is the path of consumer health insurance.

Car insurance rates can you lower them

Car insurance rates are prohibitive nowadays. Many families really struggle to pay the car insurance bill each month. And car insurance rates vary all the time. So if car insurance cost is an issue for you, what can you do about it?

The car insurance industry is a massive industry. It is also a highly competitive one, and car insurance rates vary over time as car insurance companies compete for business. Car insurance rates are often highly fluid.

It is entirely possible to lower the cost of your auto insurance rates by altering your behaviour, and you can do this by having a better understanding of how the rates are assessed.

Car insurance rates are based on an assessment of risk. Whilst insurance companies vary their rates to compete with other insurance companies, they also vary their rates based on their assessment of the risk posed by a particular driver driving a particular car. They do this because there is no point in buying business with low car insurance rates and then insuring high risk drivers at these rates. This is a recipe for losing money.

So, if you lower your risk, you lower your car insurance. How do you

lower your risk? Well there’s a number of ways that your own driving and car behaviour can affect your car insurance rates.

Have a look at the car you drive. Is it suitable for your current needs? If not then would it be worthwhile to consider a change?

Different cars attract different auto insurance rates. Sports cars, high powered cars and cars at greater risk of theft attract higher rates. How long have you had your car and would it be wise to think about another one that would be cheaper to insure and more useful to you?

Are you a safe driver? Do you stick to the speed limit? Are you at risk of other driving offences? Many people do not think about some of the consequences of speeding tickets and driving offences until after they have seen their subsequent car insurance bill.

Your risk profile is a direct result of your driving record. A clean driving record and you will be rewarded by cheaper rates. A poor driving record and you will be penalised, usually for quite a while.

Are you willing to attend driver training courses? Many car insurance companies offer specific discounts for drivers who have attended a course. Why? Lower risk.

Are you willing to drive less? Could you car pool or use public transport to get to work? Car insurance companies look at the amount of driving their clients do when assessing their car insurance rates. Why? Lower risk. Less miles driven equals less risk. And you’ll save on other car costs too.

So if auto insurance costs are an issue for you and your family there are things you can do. These are just a few of those things, there are many more. Car insurance rates are not set in stone.