by Guest » Mon Mar 04, 2013 12:44 pm
I have submitted all the proofs on treatments, along with the medical bills. Do the adjusters question the medical providers for the details? even if it's a therapist? Is that the reason why the medical release form is signed?
Posted: Mon Mar 04, 2013 02:24 pm Post Subject:
Under the Health Insurance Portability and Accountability Act (HIPAA), you must give specific written consent to another person who needs to obtain a copy of your protected health information ("PHI"). This includes an insurance company that needs to review your claim for medical necessity. Simply submitting the bill does not prove medical necessity, it only proves that a loss may have occurred.
Without your HIPAA consent and its ability to review your medical records, if necessary, the insurance company has no choice but to (1) pay or (2) deny your claim. Which do you think they will choose?
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