When you receive bills after switching insurance providers, there are several steps you should take to address the situation:
Review the Effective Date: Check the effective date of the new insurance policy and ensure that it aligns with the dates of service for the bills received. This will help determine whether the claims should have been handled by your old or new insurer.
Understand Transition of Care: If you received medical services during the transition period between the old and new insurance, consult both insurers’ policies on “transition of care” benefits. Some insurers offer continuity of care provisions which may cover certain ongoing treatments with your former provider’s network rate.
Contact Both Insurance Companies: Reach out to both your previous and current insurance providers for explanations of coverage concerning each date of service listed in the bills. Verify which insurer was responsible for coverage during that time period.
Review Policy Documents: Examine your insurance policy documentation, such as the Explanation of Benefits (EOB) statements, to understand what was covered by the old insurer and what should be covered by the new one.
Confirm Provider Network Status: Ensure that the healthcare providers in question are within the network of the new insurance plan. If out-of-network charges are causing issues, address these with your insurer and insist on clear information regarding any coverage requirements or limitations.
Investigate Billing Errors: Contact healthcare providers to verify if billing errors were made when submitting claims—this could occur if providers erroneously billed the wrong insurance carrier. Request correct invoices reflecting accurate submission to the appropriate insurer.
File an Appeal if Necessary: If there is a denial or partial coverage of claims by either insurer which you believe should have been covered, follow the dispute process and file an appeal. Both insurers should have procedures for appealing denied claims.
Legal Consultation: If you encounter persistent difficulties or disagreements unable to be resolved through direct communication, seeking legal advice or assistance from a consumer protection agency may be necessary to ensure fair treatment and clarification of your rights.
Maintain Detailed Records: Keep detailed records of all communications with both insurance companies and healthcare providers, as well as copies of all correspondence, bills, and policy documents. Accurate records can help expedite resolving any disputes.
By following these steps, you can effectively manage the receipt of bills post-insurance switch and clarify which obligations fall under each insurance provider’s coverage span.
