The Medical/HMO Insurance Claim Process
- Have all documentation prepared before responding to claim questions.
- If you do not fully understand a question, ask to have it repeated.
- If you do not know an answer, do not guess.
- Maintain a pleasant demeanor.
- Respond to questions with brief answers. Do not volunteer information not specifically asked for.
- If the person questioning you is harsh or abusive, or if you are asked questions that seem to be inappropriate, ask to suspend the proceedings until you can obtain professional advice on these matters. Don’t make passionate speeches. Don’t become angry, rude or defensive. Just say, “I’m sorry, I would like to obtain professional advice on this. I’m not familiar with proceedings of this type,” and leave without further comment.