How do I read an insurance claims loss statement?

Dr. Michael Roizen, MD
Internal Medicine

Before you try to start decoding your insurance claims loss statement, it is important to understand two things: 1) what your plan actually covers and 2) what codes your insurance company uses for billing. Once you have that sorted out, the easiest way to read the statement is to go over it line by line with a customer service representative. You may feel like you’re back in school, but it is important to take notes during your review. You can also ask what your options are for appealing the decision, if necessary. After your conversation with the customer service representative, obtain a copy of the records from your medical visits to compare with your loss statement. You want to make sure that all of the information is accurate and consistent.




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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.