The Five Key Steps in Medical Insurance Review

Medical insurance reviews provide results in a timely fashion. Filing a medical claim can be a lengthy process prone to miscommunication and breakdowns in the chain of paperwork. Bringing in an independent review organization can tap into deep reservoirs of medical expertise. The review on this level can determine an objective approval or denial of an insurance claim. The denial will be based on medical fact, however and not on anecdotal evidence.

The Five Key Steps in Medical Insurance Review

The following steps illustrate how a medical claim is reviewed.

· A patient is prescribed a treatment for a condition or injury. The medical opinion of the attending physician along with related charts and information may be submitted or requested in order to request coverage of the insurance claim.
· Medical and physician resources are provided the medical information and asked to review the treatment and prescribed recommendations.
· The medical specialist assigned to the case will provide an unbiased opinion with regard to the treatment.
· An insurance expert reviews the terms of the patient’s coverage as offered by the insurance company. They will offer an unbiased determination with regard to whether the patient is covered for the treatment in question.
· Finally, the two opinions are combined to return an objective recommendation for approval or denial.

On Time Decisions

This process allows for healthcare decisions to be made in a timely and expert fashion. The resource is invaluable for all aspects of the healthcare profession. Patients will receive approval for vital treatment that may be otherwise rejected by a large insurance company that handles its own medical reviews internally and without expert sources.

Anecdotal evidence is never used to deny a claim or pay for an unnecessary treatment. The use of third-party experts and medical specialists provides claim managers with the verification and authentication needed to do not only the right thing, but also the best thing. The medical insurance review process removes the factor of uncertainty that claim managers may face in a world of rising medical costs, complex specialization and treatments.

Avoids Ill-Informed Approvals and Denials

Healthcare costs skyrocket in an atmosphere where a claim manager must err on the side of caution to either pay for unnecessary treatment or deny one that is necessary. Without using an independent review organization, the insurance company may lack the resources to make a decision in a timely fashion.

As illustrated by the five key steps of the review process, experts from both sides of the equation are consulted. Complicated medical technology combined with equally complicated insurance policies and terms can make for a morass of misunderstanding without the right types of expertise. The process also reduces the amount of frustration felt by claim managers, patients and physicians by filtering the claims through the right hands to get the right advice and interpretations.

Fiscal Responsibility

The more approvals of unnecessary treatments, the higher insurance costs will soar. The medical insurance review process allows a claim manager to make an informed decision and eliminate unnecessary treatments. Patients and physicians rely on insurance coverage to underwrite potential treatments for a multitude of conditions.

An insurance expert understands the complex terminology of a coverage policy. Specialized physicians understand the nature of illness and treatment. The combination of expertise improves the process of treatment review and coverage approval. That means no lengthy waits for vital services and no funding for unnecessary ones.

This process has a dramatic impact in reversing the trend of rising healthcare claim costs. By dramatically reducing these riding costs, an insurance company can save money for their consumers, their shareholders and the healthcare community.

Ways to Save on Auto Insurance

The American economy is sucking a lot of money out of consumers’ pockets due to high gas prices and the general increase in every other consumer good from food to clothing that is associated with high oil prices. However, there is good news on the horizon, and that is that auto insurance rates are being reduced. Despite this reduction, there are several things you should keep in mind when shopping for car insurance to ensure you receive the best rate and coverage for you and your vehicle.

Tip #1 Shop Around
There are so many different auto insurers out there you might think it difficult to find the best insurance at the lowest prices. However, don’t despair because all you have to do is shop around. The easiest way to do this is to go online and search all your favorite car insurers in order to receive a fast and free online quote. Then, you can simply compare the services and prices of the insurers and make the best choice for you. Spending a little time on research might save you hundreds of dollars on car insurance.

Tip #2 Look for the Discounts
You may not have known this, but many auto insurers provide discounts to drivers for good driving behavior and other reasons as well. So, ask about the discounts available through various insurance providers and consider how many you would qualify for. More than likely if you qualify for one or two then your rates could easily drop several hundred dollars per year.

Tip #3 Maintain Your Credit
Unbeknownst to you, your credit score affects your car insurance rate. As a result, you should be sure to maintain your credit score as high as possible in order to not only receive the benefits of good credit, but also to pay lower car insurance premiums. It is really worthwhile, and something you will benefit from economically.

These tips are great ways for you as a consumer to take your car insurance needs into your own hands and find the best provider with the lowest rates and most coverage. When you start doing the research, you will be amazed how much money you can save as well as how many more benefits you can receive. Go ahead and start saving on your auto insurance today, there is no reason to wait.

Want to know the 7 Things your auto insurance company should give you but doesn’t?

Do you think you have the best auto insurance coverage just because you’re with a “big name” company?

News flash, you’re probably getting less coverage than you think.

But first let’s talk about accident statistics in the U.S.…

The Facts:

There are about 3 million car-related injuries a year
• 2 million permanent injuries
• 40,000 deaths in the U.S. each year

About 40% of car accident fatalities are related to drinking and driving.
• 30% to speeding
• 33% from a car going off the road

Car accidents are currently the number one killer of people ages 1 to 37.
About 1 in 30 young drivers will be injured in an accident each year.
Young drivers are four times more likely to die in car accidents.
• much more prone to speed
• drive recklessly
• not wear their seat belts
• and drink and drive

There are Approximately 6.4 million accidents each year

Approximately 40,000 people die in auto accidents each year.

You may ask yourself what are the odds of me getting into an accident?
There were 48,366 Transportation accidents in 2002.
• One year odds of You getting in an accident are 1 in 5,953.
• Lifetime odds of You getting in an accident are 1 in 77. Are you the 1 in 77 to get into an accident this year?

Did you know?
Midnight to 3 a.m. on Saturdays and Sundays proved to be the deadliest 3-hour periods throughout 2003?

In 2004 there was a total of 38,253 Fatal Crashes.
• Over 26,756 Driver crash victims
• 10,304 Passenger Victims
• 4,641 Pedestrian Victims
• 725 Pedacyclist Victims

Let’s move on to Insurance Coverage.

Here are the 7 things your auto insurance company should give you but doesn’t!

1. Full replacement cost paid if your new car is totaled in the first year at no additional cost.

2. Towing and roadside assistance included with your policy at no additional charge and no reimbursement required.

3. Bilingual insurance representatives available 24 hours a day 7 days a week to provide policy service or take claim reports.

4. Extension of your policy coverage and limits when driving in Mexico within 100 miles of the U.S. Border.

5. Discounted rates for qualified members of certain occupational groups.

6. Temporary coverage for student children home on holidays at no additional charge.

7. Waiver of collision deductibles if both parties involved in an accident are customers of the same company.

You Should You Choose Term Insurance Instead of Whole Life Insurance

“Different strokes for different folks.”

When it comes to life insurance, it’s important

that you keep that saying in mind.

Most people are familiar with “whole” life insurance.

This is the kind of insurance where you will get back a certain amount of money when it

“matures” at the end of the insured period.

What you may not know is that there is another

form of life insurance called “term” life insurance.

Similar to whole life insurance, when

you get a term life policy, you pay a sum of money (the “premium”) to the insurance

company, and in exchange the company promises to pay out a certain amount of money should

you die during the period for which you are covered under the policy.

In other words, you

are buying insurance coverage for a certain period of time.

But unlike whole life insurance,

you will not get back any money at the end of the insured period when you buy term

insurance.

You may be saying to yourself, “But won’t I be throwing money down the drain?

After all, I won’t get back a single penny after the insured period!”

Hey, I understand how

you feel. But rest assured that term insurance is still a very idea, and I highly

recommend that you use it to your advantage.

So, why should you still consider term

insurance?

Well, one advantage of term insurance is that it’s cheap. In fact, for the same

amount of insurance coverage, the premium for a term policy is only a small fraction of the

whole life policy’s premium.

And this is why term policies are a great way for you to make

sure you are sufficiently covered. If you’ve never checked out the premiums of a term life

insurance, I highly suggest that you go do it soon. You’ll be surprised at how cheap it is

to bump up the insurance coverage for yourself!

Plus, you can use the money you save from

the lower premiums to invest in some other areas that can potentially generate higher

returns for you. This strategy is generally known as “buy term and invest the difference”,

and it’s something I recommend that you take into consideration as you do your financial