Hurdles of filing a Long Term Care Claim  

Helping Hands Long Term Care Claims

A Helping Hand

One of the strengths of our long term care insurance agency is that we both sell and help family file claims on their long term care policy.   When we file your claim we deal with the same road blocks that you do, we just know how to get thru them faster.  Here are some typical hurdles that have to be overcome to successfully file a claim

  • HIPAA

  • – as frustrating as this may be for you, it is the law and the carriers are bound by it: they cannot legally talk to anyone about the claim except the policy holder or the person(s) the policy holder has designated as having permission.  This usually means a signed HIPAA release (a very specific form) and/or  filing your Durable Power of Attorney and a signed release if the policy holder is no longer able to sign for him/herself.
  • Record keeping

  • – claims require a great deal of documentation to get the claim started. But even after it is up and running, there is still paperwork to manage every month.  If you don’t track things like who you are talking to and what was sent or said and if you aren’t keeping a running log of dates of service that have been submitted and paid or denied, then you have no idea whether you are gaining ground or losing ground on your claim.  We keep a contact log here – it date/time stamps every interaction we have on the claim so if there is ever a questions we can go back and read exactly who did or said what and what dates of service are billed/paid/outstanding.  We highly recommend you do the same.

 

  • Confirm Fax Receipt

  • A pox on the FAX! – I am old enough to remember the first, miserable fax machines. You’d think nearly 30 years later fax technology would be smooth, seamless and highly reliable.  It is not.  Do NOT assume that a fax you sent arrived in its entirety and got put in the file completely.  When we fax out anything (to the doc, the rehab, the carrier….anyone!), we track it in our contact log and follow up one to two working days later to be sure all the pages arrived and that they are all in tact in the file.  Really…you just can’t trust that it is working.  There are still humans involved after all…

 

If you have no idea where to start, download our free claim worksheet from our website WorkSheet at MRSLTC or you can purchase the claim filing guide thru Amazon or Barnes and Noble (kindle/nook versions as well as hard copy).  It is called:  Long Term Care Claim Filing:  A Guide for Dutiful.

Some Additional Links to help you

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