Communicating with healthcare providersCommunicating with healthcare providers
When communicating with other institutions, it is always important to get all the information in a very clear and understandable manner. It is useless getting all the information they can provide if you dont understand what it means. Also, it is useless understanding the information you have if it is incomplete. When following up medical information, it is essential you can as much information as you can and that you understand the information you are being provided with. This can spell the difference of having your claims settled completely and quickly.
Healthcare providers sometimes talk in legal and medical terms when providing replies to queries on electronic patient statements. Usage of legal and medical terms is most often the correct and proper reply. If it is translated to laymans terms, it may lose the exact meaning and lead to misunderstandings and confusion. The staff of insurance companies is trained to give standard corporate and medical replies to queries. If you want a clearer laymans explanation, you may have to talk to a manager or someone else who is more experienced in explaining the legal and medical terms in laymans terms. If there is no further explanation provided, you can ask them to send their reply via email or other written correspondence so you can use it to inquire from other sources. Normally, the reply to a query opens the conversation to more inquiries. Do not leave the topic until you have exhausted all questions regarding it. Some people become satisfied with the initial replies that they fail to dig deeper into the topic. For instance, if you are following up a claim and the provider replies that they are reviewing it, you should follow it up with other queries. There may be some information that you can explain to them at that moment to expedite their review. If they have too many claims at the moment, you can ask for a date on when they can expect it to be completed. You can follow up if the claim is still outstanding at that date. Make sure the answers are complete and satisfy you thoroughly. Probing questions will bring out other replies that may help you understand the complete situation. Healthcare statement processing is an automated process but most people understand what procedures are entailed in the statements and the charges related to those procedures.
You can help the healthcare provider by volunteering additional information. Some providers are cautious about giving private information to anyone, especially if they dont know you. By offering information, it will show them you are the patient involved in the claim. They may be more open with their replies when they know who they are talking to. Also, the additional information you give them might help expedite the processing of your claims.
Write the names of the people you talked to and the date and time of the conversation. Normally, all communication is recorded so management can review the conversation and perform appropriate actions. Stay calm and professional when talking to the people. Establish rapport with the person. If you are not satisfied, request to talk with a more senior person. If you think of other questions later on, you can call them up again for further clarification.