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3: Analyze Your Circumstances

Hone Your Skills for Challenging and Negotiating

Challenging a medical charge or insurance denial of service and negotiating for lower rates may not come naturally. Here are some guidelines for increasing your skills.

  • Follow the instructions. Your insurance carrier provides instructions on how to file an appeal.
  • Be pleasant and respectful. There is no need to treat the insurance staff or customer service person like a villain. Smile and be personable. You are more likely to receive the same or better treatment.
  • Rely on facts. Complete your homework before you make contact so you know acceptable rates and understand your insurance coverages.
  • Know what you can pay. Know how much you can afford for a medical service and what your insurer is paying to make a settlement offer.
  • Know what you want and explain it. Discuss one thing at a time so you (and the person on the other end) can make progress.
  • Ask for follow-up. Define the next step, who needs to approve plans and who will make contact next. If possible, set a date for the next conversation.

Particular to insurance denials, understand the process for appeal. Patient Advocate Foundation has resources available for working specifically with insurers as well as identifying advocates who can work with you.

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