Russia Health Insurance Claims
In order to receive reimbursement for any medical treatment you may have received under your Russia health insurance plan you will need to submit a claim to the insurance company.
When choosing your insurance company, pay particular attention to their capability in claims processing as well as their credibility on the market. It is in your utmost interest to get your claims processed in the most efficient and smooth manner.
There are several upsides to purchasing your health insurance through a globally reputable brokerage firm. Brokers will provide you with impartial advice in regards to choosing between different medical insurance plans and help you find most cost-effective plan options. In addition to that they can help you handle your claims and make sure that your medical insurance plan is working effectively for you. Keep in mind that the cost of the plan will be the same whether you go through a broker or deal directly with an insurance company.
Types of Health Insurance Claims
There is a great advantage to understanding how the claims process works as it will help you get reimbursed as quickly and efficiently as possible.
As a standard industry practice there are several types of claims that can be made under medical and health insurance plans in Russia.
In-Patient Health Insurance Claim Treatment Guarantee
In the case where you have a scheduled In-patient medical treatment it is highly advised that, before being admitted to the medical facility for the treatment in question, you submit Treatment Guarantee Form to your insurance company. This will enable direct communication between the medical facility and your insurance provider making the confirmation of the full payment for your medical treatment much easier.
In-Patient Emergency Treatment Claim
If in the case of an emergency where you were admitted to the medical facility for in-patient treatment and subsequently did not have time to file the Treatment Guarantee Form in advance, you most likely would have to cover the treatment fee yourself. You will be reimbursed once you have submitted the claims form with all the necessary documentation to your insurance provider.
Make sure that you, or anyone on your behalf, contacts your insurance provider as soon as possible in order to enable a prompt settlement of the medical treatment fees and/or swift reimbursement for your independent expenditure.
It is important to know how to correctly fill in the claims form, as well as being aware of the documentation that is usually required. Being familiar with the claims procedure in advance will prove extremely useful in prompt settlement of the medical treatment fees.
Out-Patient Direct Settlement
If you have purchased a plan that offers an Out-Patient Direct Settlement option the only thing you would need to do when receiving your outpatient medical treatment is to present your health insurance policy details. The bill will be subsequently settled by your medical insurance provider.
This option is possible due to the large network of different hospitals, clinics and other medical facilities that your insurance provider may have an agreement with. The more reputable you insurance provider is, the more likely you are able to receive out-patient direct settlement in the clinic or hospital of your preference.
General Out-Patient Claims
Under the General Out-Patient Claims option, the medical treatment is normally initially paid by the policyholder. After gathering all the necessary documentation and paper work you will be able to submit the claim to your medical insurance provider.The manner in which you are later reimbursed may be of your preference.
Common Issues with Health Insurance Claims
At Russia Health Insurance we have wealth of experience in dealing with Health Insurance matters. One of the most often occurring issues that we have observed concerns claims and reimbursement. Very often the claims paperwork is not complete thus prolonging the time in which the insured individual is reimbursed. Similarly the necessary documentation, such as treatment receipts, is not always provided to the insurance company – further prolonging the claims process.
In quite a number of cases there seems to be a lack of understanding in regards to what is and is not covered under individual's health insurance plan. This often occurs because the term pre-existing condition is not always well understood. Pre-existing conditions are typically not covered under most of the medical insurance plans currently available on the Russian insurance market and thus the treatment fees can not be reimbursed.
Common issues with regards to the health insurance claims process in Russia include:
Pre-existing medical conditions
Unless you have purchased a plan that does cover pre-existing medical conditions, medical fees associated with the treatment of the pre-existing conditions are usually not covered under you health insurance policy.
Please follow the provided link in order to better understand what is considered to be a pre-existing medical condition under Russian health insurance.
Claims made for pre-existing medical conditions will most likely be automatically rejected. To avoid disappointment and frustration do read your health insurance policy carefully and thoroughly understand what is and what is not covered under you Russia medical insurance plan.
When you file an insurance claim be extra diligent with including all necessary receipts and supporting documents. Make sure that all the signatures and authorizing stamps are also in tact. This will enable your insurance provider to process your claim in a most efficient manner.
Often occurring difficulty with obtaining prompt reimbursement lies with incomplete or inadequate paperwork and documentation that is submitted to the insurance provider.
We have noticed that those who acquire insurance from globally reputable health insurance brokers tend to have fewer difficulties with claims and reimbursements. That is due to the fact that good insurance brokerage firms tend to have their own in-house claims teams that can handle and oversee the claims process on behalf of their clients.
Russia Health Insurance Information
If you would like to know more about the ways health insurance claims are handled, what additional things to look out for when signing your medical insurance plan or if you need to find more information on any particular claims option please contact us. Alternatively you also have the option of requesting additional information on the Russian claims process by completing the form at the top of this page. At Russia Health Insurance our dedicated advisers will help you gather all the information you need in order to make most informed decision when purchasing your medical insurance policy.