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

What You Need to Know About Pet Health Care Insurance

Before you purchase a pet health care insurance plan for your pet, check the list of the companies approved veterinarians to see if your veterinarian will accept the companies check.
Ask your local veterinarian what type of pet health care insurance plan would best suit your family pet. Ask your local veterinarian to read over the plan and listen to their advice. Talking to your local veterinarian will also help you establish if the insurance company you are considering purchasing your pet health care insurance plan from is reputable.

If you have purchased a pet that is as of yet unaltered you’ll want to look for a pet health care plan that includes neutering and spaying.

Before you pay for a pet health care insurance plan you need to carefully read how the policy handles prescription coverage. Most companies that sell pet health care insurance do not include prescription coverage in their basic medical health care insurance plan. If you are concerned about the cost of any prescription your pet might need during the course of its life you should probably consider buying a prescription coverage rider to complement your pet health care insurance. Although this rider may appear expensive and unnecessary you’ll probably wish you had purchased it if your pet is ever given a prescription for anything. Just like the human counterparts prescriptions are very expensive.

One of things you need to take into consideration when purchasing a pet health care insurance plan is the deductible. The deductible is the amount of money you pay out-of-pocket for veterinarian services rendered that your pet health care insurance plan does not cover. Different pet health care plans require different deductibles. The higher a the deductible you choose the lower your monthly payments to the insurance company but the higher deductible the more out-of-pocket extension had each time you visit the veterinarian’s office/clinic.

Most pet insurance companies have “cap” or limit placed on each pet health care insurance plan. This cap varies from one procedure to the next a broken leg will probably have a different cap then cancer treatments will for your pet. Before you purchase your pet health care insurance plan talk to the company representative about waiting periods. Find out exactly how long it’ll take over the policy to be effective and how long the general wait for claims to be reimbursed is. Most companies have a ten day period between the time they receive the vet bill and when the check gets placed in the mail. Also find out how the refund is processed. Does the pet health care insurance company pay the veterinarian directly or do you have to pay the vet and the company mails the check to you when they receive the bill.

Why you have the company representative on the phone task about any and all exclusions that might be included with your pet health care insurance plan. Specifically ask about any and all pre-existing conditions and hereditary defects that might come up later in your pet’s life. Many pet owners especially, those that have dogs, discover that hereditary defects come into their particular dogs are not covered by their pet health care insurance plan. Some companies will allow you to cover these potential problems with an additional rider. In some cases your local veterinarian will be able to warn you about any exclusions.

If you are considering a comprehensive health care insurance plan ask if the plan covers teen veterinarian visits such as; dental care, immunizations, and heartworm testing. Also ask if the pet health care insurance plan also covers the office call.

What you need to know about insurance

Getting an insurance is one of those ‘life’ requirements that you should be looking into early in your career, especially now when you are still able to work and earn money. in addition to being better able to pay for the insurance, younger individuals also pay less. This is one of the principles of insurance. Since younger people are less likely to die, they are given cheaper rates as compared to older individuals.

Insurance protect financially you and your family in the future. Depending on the kind of insurance that you will choose to get, insurance can even provide for your health concerns, for your retirement and even for your death and burial.

But while it is important that we are protected against any unexpected eventualities, some people still shy away of availing insurance on their own, preferring their companies to do it for them. Like legal matters, all those insurance mumbo jumbo tend to confuse and sometimes even frighten people.

Here are some of he frequently asked questions about insurance.

What are the kinds of insurance?

There are two major types of insurance. The life and the non-life insurance. The life insurance, as the name suggests, protects the family of the person in case something happens to him. When a person who is insured dies, the money that he insured will be given to the beneficiary that he has chosen.

The non-life insurance is an insurance that protects properties. Under this category, there are several different types. There car insurances, which protect automobiles from wreckage in case of accidents; property insurance, which protects properties especially houses from fire and other forms of destruction; deposit insurance, which most banks have in order to protect their depositors from losing their money in case the bank suffers financial setbacks; and health insurance, which helps in covering for medical and hospital costs. Among the various non-life insurance, the most popular is the health and car insurance.

Some insurance also provide for the future. Some of the insurances are retirement plans and death plans, which covers for burial costs.

What is the difference between a premium and a face amount?

Premium refers to the amount that you have to pay every year for the insurance. Some insurance companies also offer to divide the premium into monthly installments to help their clients. The face amount on the other hand is the amount that you have insured yourself into. For example, if the face amount in your policy is set at $500,000, then your beneficiary will receive $500,000 when you die.

What do you mean by double indemnity?

Some insurance policy offer an accidental clause that would double the face amount in case death has been established as accidental. This is done to protect the insured’s family in case of an untimely death. Double indemnity means that the face amount will be doubled when death is accidental.

Is the beneficiary always the legal spouse?

No. Contrary to popular opinion, it is not always the spouse who is the beneficiary. It is up to the person to choose, who he names as beneficiary. It can be any member of the family as long as insurable interest is established. If in case, the children are named beneficiaries and are still not in legal ages, a ardian will be named to assume control of the money for them.

Wedding Insurance

Most people carry some form of insurance such as auto, medical, life, etc. Since the average cost of the more than 2 million weddings in the U.S. is over $20,000, wedding insurance can cover billions of dollars caused by damages. With so much money spent on weddings knowledgeable couples incorporate wedding insurance into their overall wedding planning strategy. Wedding insurance offers protection against something going wrong, the wedding being cancelled or postponed.

Wedding insurance allows for flexibility in coverage. Just to mention a few, policies may cover for cancellation, unforeseen expenses, wedding gown, video and photographs, jewelry, venue property, gifts, liability, medical expenses. Depending on the coverage wedding insurance can cost as little as a couple of hundred dollars.

Some of the most common items covered by wedding insurance are:

Jewelry: This coverage is designed to replace or repair damaged wedding rings.

Liability: If someone falls on the dance floor, it can cover some of the medical expenses. Some wedding reception venues may require such insurance in the contract. This policy can also help if someone of the wedding party damages equipment or furniture. Without this coverage you and your new spouse may find yourselves in court with one of your wedding guests.

Weather: Unfortunately, natural disasters have been part of our lives, and for the most part unavoidable in the future. This type of coverage is very much influenced by your geographical area.

Video and Photography: This coverage will help you to reunite the wedding party in an event when your photographer is a no show, or the photographs are defective or damaged, the negatives are lost, etc.

Service Providers: This coverage will help minimize the damage caused by vendors who fail to provide a contracted product or service, it can cover such as non-refundable deposits, and expenses occurred due to finding new vendors.

Although you can’t insure against a gloomy day, you can certainly insure against disasters such as hurricanes or fires. Wedding insurance can cover just about everything except for a change of heart. Disasters and mishaps will have their toll on your overall wedding experience, but you can minimize the long-term effects by obtaining wedding insurance.

Understanding Your Auto Insurance

Reading auto insurance policies can be like trying to decipher advanced calculus. It’s really not that difficult if you understand a few basic terms. Collision, Comprehensive, Bodily Injury Liability and Property Injury Liability are the main terms you need to fully understand.

You’ll appreciate Collision Coverage in the event you need repairs or replacements if your vehicle collides with another vehicle or property. The higher the deductible you elect, the lower your premiums will cost you. If you’re at fault for something, well of course it would still be an accident, as I doubt you’d plan to run into that guard rail, but how much would you be able to afford to pay out of pocket for repairs? $250? $500? $1,000? Just like medical insurance, you’d have to pay that deductible amount first and then the insurance company would pay for the remaining charges for the repair.

Another term to become intimately familiar with is Comprehensive Coverage. This is the coverage that pays for damage caused from falling objects, fire, certain natural disasters, theft and vandalism. Deductibles work the same way as with Collision; the more out of pocket costs to you, the less your insurance premium.

In addition to knowing how much Collision and Comprehensive coverage you have, you’ll want to know about your liability coverage. Let’s say you rear-end another driver. Or your foot slips off the brake onto the gas pedal and you plow down a mailbox. Your liability coverage will kick in and pay for the damages that you caused with your insured vehicle. You liability coverage will, or could, include bodily injury (people) and property damage.

You don’t want to go without Bodily Injury Coverage. If you were at fault in an accident and others involved needed to go to the hospital and/or lost wages from missing work, those costs would come out of your pocket if you are not insured with Bodily Injury Coverage. It doesn’t take a genius to know how quickly those amounts can add up. This type of coverage can also help you in the event the other party takes legal action against you. Many states require you to carry Bodily Injury Coverage.

The other part of liability includes Property Damage coverage. Can you imagine how much it might cost should you accidentally drive into the side of someone’s home? You wouldn’t want to be caught without property damage insurance should you need to pay for repairs to another vehicle, building or anything else you might hit. As with Bodily Injury coverage, Property Damage coverage also helps protect you in the event of a related lawsuit.

Every policy will have its limits and various degrees of coverage. It’s important that you understand the basics of what you are paying for and why it is necessary. No one plans for an accident, be prepared!

Understanding Those Terms On Your Home Insurance Policy

Buying a home means that you will be required by a lender to have home insurance. It provides protection for you in the event that anything should happen to your home. The protection can cover many things – or a few – depending on what kind of coverage you have. If you are either about to buy a home insurance policy, or have forgot what your policy covers, here is some help for you to understand some of those terms.

Before you start, though, you should have a real good idea of what your house and outbuildings are worth. This will enable you to look at the various terms and understand which form of insurance, and how much you need from the start.

Actual Value Versus Replacement Value

These are the two ways that you can be covered in a home insurance policy. Actual value means that you assign a fixed value to your home, and you will be covered only up to that amount. However, know that this also includes depreciation, meaning that the older your house and possessions are, the less you will receive. Certainly this is the less expensive way to go, and many states no longer offer it, but you could end up getting less than 50% of what you paid for your house. Unless you have a large bank account somewhere, you could not rebuild your house on this amount today.

Replacement value, on the other hand, is the better deal. It offers to replace your house or contents – no matter what the cost. Depreciation really does not even enter the picture. Neither is there a ceiling on the limits, either. In other words, if your house is worth $100,000 and becomes destroyed, you will get an equivalent house built for you – even if it costs $120,000 to do it.

Event Coverage or All Events

Home insurance can be purchased covering what is called “events,” or “all events.” Event coverage means that it will cover you when certain events occur – but only those events. Generally, you can get this type in different levels, covering more or less events of possible loss. All event coverage, however, will cover everything with the usual exception being that of flood, earthquake or hurricane. This coverage usually must be purchased separately – if you want it.

Content Coverage

All of the contents of your house can be covered, up to a certain percentage of the value of the house. Generally, it is a high enough percentage that most of your contents are covered. In order to receive a recompense of your contents, however, it is best to have a careful inventory. This is generally best accomplished by taking a video camera through each room of the house and recording your various comments about the items – one at a time for the more valuable contents. You will even want to go through your closets and basement in order to show everything. This is especially true of jewelry, art, and other valuable items you possess. This type of item may also require special insurance.

Visitor Health Insurance and Visitors Medical Insurance

Visitor Travel Medical Insurance plans sometimes referred to as Visitor Medical Insurance or Visitor Health Insurance plans can be purchased anytime even during the middle of a trip.

Medical emergency is a situation when a life-threatening medical condition existed, or the lack of medical attention would endanger his or her life, limb or sight and requires immediate medical treatment or has painful symptoms requiring a relieve to suffering or discomfort. Many Travel Health Insurance plans focus on providing coverage for your medical expenses resulting from sudden illness or injuries during your trip, with many policies covering trips from seven days to 3 years.

Many people find that understanding Visitors Medical Insurance can be a challenging process because there are numerous insurers with many different kind of plans, different deductibles, various coverage options and restrictions. Purchasing a plan that caters to your needs is not always easy. You can actually make your decision making process easier by taking advantage of the tools offered by the insurers’ website. It can help you to compare all major insurance plans, get free instant travel quotes and purchase a plan that best meets your specific needs.

Many insurers have offered the option of purchasing a Visitor Health Insurance online and this can get very misleading for many people because they thought that they can get immediate visitor health insurance coverage online. You should be aware that Visitor Health Insurance policies may establish a certain waiting period before it covers pre-existing conditions which are health problems you had before you bought the insurance, as long as the waiting period is reasonable by current standards set by the insurance associations.

If you think a Visitor Health Insurance is too pricey, you can save money on Visitor Health Insurance by obtaining a Dental Discount Card and an RX Prescription Card separately from your visitor health insurance program.

Visitor Travel Medical Health Insurance is ideal for tourists to US, for parents and other family members visiting the United States. The medical expenses at overseas can be very high especially when it involves hospitalization.

You can reduce the financial risk of unforeseen accidents or medical emergencies by buying visitor medical insurance.

Lastly, if you travel frequently to foreign countries you should get a Visitor Medical Insurance because with sufficient health insurance coverage, you can reduce the financial risk of unforeseen accidents or medical emergencies. Most importantly, you won’t have to see situation going catastrophic