How to avoid health insurance claim rejection?

Understand Your Policy

Know the specifics of your insurance plan, including what is covered, excluded, and any pre-authorization requirements.

Verify Coverage

Before receiving any medical treatment, confirm with your insurer that the service is covered under your plan. Ensure that the healthcare provider is in-network.


Obtain pre-authorization if required. Some procedures or treatments require prior approval from the insurance company.

Accurate and Complete Information

Ensure that all the information provided on the claim form is accurate and complete. Any discrepancies can lead to rejection.

Timely Submission

Submit your claims within the stipulated time frame. Late submissions can be a common reason for rejection.

Follow Guidelines

Adhere to the guidelines and procedures set by your insurance provider. This includes using the correct forms and providing all necessary documentation.

Keep Records

Maintain copies of all bills, receipts, and communications related to your medical treatments and insurance claims.

Communicate with Providers

Ensure that your healthcare provider submits the claim correctly and provides all required documentation.

Appeal if Rejected

If your claim is rejected, review the reason for the rejection and file an appeal if you believe the rejection was in error. Provide any additional information or documentation required.

Seek Help

If you're unsure about the process, seek assistance from a healthcare advocate or a professional experienced in dealing with insurance claims.