Here are some tips to help you get the best results from your phone
calls, whether you have Original Medicare or get your
benefits through a Medicare private health plan (such as an HMO, PPO or
PFFS). They both need the same basic information.
Before you pick up the phone to call the insurance company, either on
your own behalf or on behalf of a loved one, make sure
you have carefully read all the documents you want to discuss.
Make a list of questions you plan to ask or items you want addressed so
you don't forget any while you are on the phone.
When you are ready to call, have all of the documents and your list of
questions in front of you for ready reference. And be
ready to share the following information:
* The insured person's birth date;
* The insured person's
insurance policy number and
Social Security number;
* The name and address of
the organization that sent the
* The total amount of the bill;
* The diagnosis code on the bill;
* The Medicare Summary Notice from Medicare or the
of Benefits from your Medicare private health plan (if you are
questioning an insurance payment).
Once you are on the phone
* Always write down the name and telephone extension
of the person handling your phone call. If someone is unwilling or
unable to help you or tell you their name, ask to speak to the
* Take good notes, jotting down the date of the call
and the information you were given, including what you were told would
be done or you should do.
* Be patient, since you will
probably spend some time navigating automated telephone menus and
waiting on hold.
If the insurance representative asks you to submit additional
* Send it right away and
* Keep a copy of anything you send.
Remember: If you have questions about your insurance coverage, don't be
intimidated by call center requests or complex
telephone menus--you have the right to get answers.