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Medicare: Claims - How To Find Professional Assistance

What To Look For In A Professional To Help With Claims

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Unfortunately, there is no degree, licensing requirement or standard criteria to help you identify a qualified professional to help you with your health claim(s). In fact, from our experience, there isn't even a particular specialty that is more helpful than another.

The type or organization or reputation of the organization is not as important as the qualifications of the person who will actually be helping you.

NOTE: Medicare has as many differences as similarities with private health insurance plans. Make sure the person's experience is with Medicare, not just health insurance in general.

When considering any particular individual, find out:

  • Does the person understand what you are talking about?
  • How well does he or she know Medicare? Did the person learn it through experience or training? If experience, how long and in what circumstances? If training, where and for how long?
  • How familiar is he or she with your type of problem?
  • What would the person suggest as a plan of action? Include what needs to be done, and in what order.
  • How long does the person expect the process to take?
  • What are the possible outcomes? Can the person give you an idea of how likely each outcome is?
  • How much will the person's services cost at a minimum and maximum? When does payment have to be made?

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