March 3, 2022

Latest “Under the Coverage” episode shares insights on how insurance companies handle medical claims

Ever wonder why your provider asks if you have “other insurance” or why your claim was denied because you didn’t obtain authorization for medical services from your insurance company? Hear from one of Nova’s claims adjudicators who explains this and more in our latest podcast, “Prior Authorizations and COBeasts.”

This week’s episode of “Under the Coverage” focuses on the complex world of medical claims. Topics covered include prior authorizations – or the need to receive approval from your health insurance company for a medical service prior to a procedure – as well as Coordination of Benefits or COB, which involves sorting out who is paying when you have more than one insurance plan. While claims adjudicators are responsible for ensuring medical services are billed and paid correctly behind the scenes, there are actions you can take as a health care consumer to help that process go smoothly and to be sure you’re paying the correct amount for care.

“My best advice would be if you get something in the mail from any provider, regardless of what kind of service they provide, and it’s a pretty hefty amount and you’re questioning it… just give your health insurance company a call,” recommends this week’s guest.

Under the Coverage features people who spend their working days focused on health benefits and health care, sharing their insider tips on information they wish every health care consumer knew. New episodes are added weekly and are available on SoundCloud, Stitcher, Spoify, Apple Podcasts and Google Podcasts. Episodes are 15 minutes or less.

Have an idea for a future episode or a question you’d like answered? Find Under the Coverage on Twitter @UndrTheCoverage or email podcast@novahealthcare.com.