If you have treated at several different facilities or have a large MedPay reimbursement limit, it may be extremely helpful to submit documentation by facility instead of all at once so that you can keep track of what you have sent and what has been reimbursed. Some companies will submit reimbursements in pieces, and it is much easier to track or follow up on a reimbursement if you know exactly what you sent and the exact date you sent it.
Collecting/Reviewing the Reimbursement
This phase of the MedPay reimbursement process is often the trickiest. There are several factors that come into play at this point that can affect your next steps, and they may impact how difficult reviewing your reimbursement becomes, including the amount available to you, the number of facilities you have been treated by, and the extent of your treatment.
Ultimately, an insurance adjuster will do one of the following when medical bills are submitted for reimbursement: a) reimburse for the expense b) deny the expense c) partially reimburse the expense or d) ask for additional documentation. Depending on the action taken by the adjuster, a follow-up action by you is often required.
Which of the four ways the adjuster has responded will determine the appropriate follow-up action you should take next. If at any point in this process you are unsure about what has been reimbursed, ask your adjuster for a Medical Payments Log, which will reflect what has been paid out so far.
If your medical expenses do not exceed your MedPay reimbursement limit, the adjuster will confirm with you that there are no new treatment facilities or any outstanding bills you will be submitting, and they will close the claim. It is a good idea to match all checks and explanation of reimbursements up to the documents you submitted so that you can make sure you have not forgotten to submit a bill.
Once your entire medical payments reimbursement limit has been maxed out, the adjuster will close the claim and will likely send you a letter called an “exhaustion letter,” which states that you have no more MedPay available to collect.