I recently received a letter from a “payment integrity solutions” company that was retained by my health insurance company seeking information about a recent claim submitted by a provider I went to. The letter says that the firm is retained to “review claims of injury or illness that may have been the result of getting hurt at work, on commercial premises, or a motor vehicle accident.” The purpose seems to be to investigate whether someone else might be responsible for paying the costs of care. Strangely, the letter doesn’t specify what claim they need more information on (I’ve received care for multiple things), but I’m assuming it’s for a sports injury I got while working out at a rec center.
My injury did occur on commercial property, but it was just a totally ordinary sports injury and had nothing to do with the safety of the facilities. I don’t love the idea of them going after the rec center owners or otherwise causing problems. I also don’t really give a shit that the insurance company has to pay for some x-rays and casting. That’s why I have insurance, and I always have to fight with them to get reimbursed for care that’s clearly covered by my plan. The last thing I care to do is help them avoid responsibility for paying out claims.
Do I actually need to fill this out? The claim has already been processed, and the letter doesn’t say that I’m required to respond per the terms of my plan. Appreciate any input from anyone who’s encountered this before.
submitted by /u/attarock
[link] [comments]I recently received a letter from a “payment integrity solutions” company that was retained by my health insurance company seeking information about a recent claim submitted by a provider I went to. The letter says that the firm is retained to “review claims of injury or illness that may have been the result of getting hurt at work, on commercial premises, or a motor vehicle accident.” The purpose seems to be to investigate whether someone else might be responsible for paying the costs of care. Strangely, the letter doesn’t specify what claim they need more information on (I’ve received care for multiple things), but I’m assuming it’s for a sports injury I got while working out at a rec center. My injury did occur on commercial property, but it was just a totally ordinary sports injury and had nothing to do with the safety of the facilities. I don’t love the idea of them going after the rec center owners or otherwise causing problems. I also don’t really give a shit that the insurance company has to pay for some x-rays and casting. That’s why I have insurance, and I always have to fight with them to get reimbursed for care that’s clearly covered by my plan. The last thing I care to do is help them avoid responsibility for paying out claims. Do I actually need to fill this out? The claim has already been processed, and the letter doesn’t say that I’m required to respond per the terms of my plan. Appreciate any input from anyone who’s encountered this before. submitted by /u/attarock [link] [comments]Read Morer/HealthInsurance