Group Benefits Claims - Questions

laraha

New Member
1
Why don't insurance companies do direct payments to service providers? Why do clients have to pay the full amount up front? Why it takes 2 weeks to get reimbursed by the insurance company?
 
Why don't insurance companies do direct payments to service providers? Why do clients have to pay the full amount up front? Why it takes 2 weeks to get reimbursed by the insurance company?

correct me if im wrong but this appears to be a question geared towards non-par providers because you said "pay full amount up front" & "reimbursement". the direct payment im a little lost on but again im thinking you're referring to a non-par provider. please confirm and i can further assist.

if my assumptions are correct than the answer is simple, because this is a non-par provider then there's no contract. i can further explain if need be
 
correct me if im wrong but this appears to be a question geared towards non-par providers because you said "pay full amount up front" & "reimbursement". the direct payment im a little lost on but again im thinking you're referring to a non-par provider. please confirm and i can further assist.

if my assumptions are correct than the answer is simple, because this is a non-par provider then there's no contract. i can further explain if need be

Translation: non-par=non-participating provider. Most if not all plans these days have "networks" of providers. If you don't use a network provider, you may have to file a claim and will owe more for your care. It's also possible you are not covered by a network plan, and may not have true major medical coverage. Need more information.
 
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