Tips for an easy health insurance
claims process
By Geoffrey Mann- March 27, 2022
Tenzing’s Tips for an Easy Claims Process
Step 1
Refer to an expert beforehand
Step 2
Get the insurance company to pay up front
Step 3
Submit to the insurer
Step 4
Update with additional information as needed
Step 5
Receive your payment and EOB
Step 1: Refer to an expert beforehand
Tenzing has a full-time, dedicated staff of support specialists, whose role is to assist clients with a wide range of insurance and medical care provider issues. Unsurprisingly, this team spends a good deal of time on claims and we recommend that you take advantage of their skill and experience by contacting them BEFORE any significant medical procedure.
Your policy may have pre-approval requirements for even minor surgeries. There are a million things that go wrong with direct billing arrangements. They can tell you what kinds of documentation you might need for a claim and can even help you find a doctor.. Contacting support@ten-pac.com in advance dramatically increases your chances of a straightforward experience.
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Step 2: Get the insurance company to pay up front
Step 2 involves the insurance company paying for your care up front, rather than you paying and submitting a claim for reimbursement. If the insurer already has a relationship with the medical provider, the direct billing network may handle the payment for you. If there’s no existing relationship, it’s sometimes possible to establish a guarantee of payment arrangement.
In either case, it’s important to contact the medical provider in advance, if at all possible. Some level of confirmation will be involved, which may take time. If there are issues, the Support team may be able to assist.
There are a number of situations where these arrangements might not be provided under your policy, such as outpatient services. But if possible, it’s always better for the insurance company to pay the medical provider directly.
The next step is submitting your claim after paying the provider.
Steps 3: Submit your claim
Sounds simple, right? The reality is often more complicated. Tenzing works with more than 50 insurance providers, with offices in Vietnam, Thailand, United Kingdom, Hong Kong, France, Singapore … each of which is subject to different local laws governing claims processing. In addition, the providers themselves and their reinsurers have their own requirements. So our Support team has a wealth of experience in this area. Here’s some of their advice:
Understand the process. Most insurers provide some sort of guide or instructions on how to submit a claim. Read it before you seek care if at all possible; this way you’ll know what documents to ask for. It’s much easier to get documentation from a hospital while you’re a patient than to request it when you’re facing a claim submission deadline.
Meet your deadlines. Often, insurance providers aren’t permitted to extend deadlines, so don’t wait.
Steps 4: Update as needed
Documents, documents, documents. Southeast Asia is infamous for red tape; it’s a fact of life that extends to insurance providers. Accept it and take steps to make the process easier.
Don’t hesitate to ask for help. Tenzing customers can seek assistance from the Support team, especially when you’re facing documentation challenges. They can work with both medical and insurance providers to find that magic sheet of paper with the right information, signatures, red stamps, etc. so you can get reimbursed.
Step 5: Receive your payment and EOB
Unlike some countries in the west, payments in Southeast Asia are done almost exclusively by bank transfer. Make sure the insurance company has accurate information! Unwinding a faulty transfer can take weeks.
Your payment will be accompanied by an Explanation of Benefits (EOB) that outlines which expenses were reimbursed. The EOB will also show any treatments that the insurer determined were not eligible. Again, the Support team can help you understand these documents and even follow up with the insurance company if a decision seems wrong.
