The Medicare Whisperer: Making Medicare Calls Easy

On n your list of daily to-dos, calling your Medicare insurance company likely isn’t a favorite. However, life happens; you receive an unexpected bill from your provider, a denial on a previously authorized procedure, or you’d just like to get an idea of cost before stepping into a specialist’s office.

 

Before you pick up the phone, to get the most from a call to your Medicare insurance company, the following can help you prepare, saving you time and frustration.

 

• Start with Your Card. On average, it takes 27 seconds for an unprepared caller to locate their Medicare ID card. And while 27 seconds doesn’t sound like a lot, consider what you can do in that time: water a plant, text a friend, or just take 10 breaths to reduce stress.

 

• Procedure Codes. Asking your provider for procedure code(s) and date beforehand will help the representative determine out-of-pocket costs. Also have the date of the procedure handy — believe it or not, it can affect your co-payment amount.

 

• Have pen and paper ready to write down information or questions.

 

• Minimize background noise. Turn down the TV, calm your dog, set aside that crinkly bag of chips, and ignore the few dishes in the sink. Call when you’re settled, not from the car.

 

• Minimize hold times. Avoid calling on a Monday, and the day before or after holidays. Long hold times can also be expected during the Annual Enrollment Period, Oct 15 to Dec 7.

 

• Speak slowly and clearly. If you can’t hear or understand the representative, ask them to slow down or to speak louder.
• Be clear and concise about the purpose of your call. If discussing a claim, provide the date of service, name of provider, and relevant billing details.

 

• When checking the status of a prior authorization, identify the provider or facility, date the authorization was submitted, and the procedure.

 

If your issue requires further research, the representative will schedule a follow-up call with you.

Be aware, during your phone call, you have the right to:

• Request the representative’s name, and the call reference number.
• Receive clear explanations of your benefits, claims, and plan details.
• Request plan documentation.
• File complaints, grievances, or claim appeals.
• Have your concerns escalated, if necessary.
• Most importantly, you have the right to be treated with respect!

A little thought and preparation before calling your Medicare insurance company goes a long way in providing you with answers, empowering you, and saving you time.

 

You now have an extra 27 seconds — what are you going to do with it?

Julie VanDyke

50plus Magazine

Julie VanDyke is a freelance writer committed to simplifying Medicare for all.