How to Fill Out a Health Insurance Claim Form

How to Complete the Health Insurance Form

1.

Download and print a copy of the claim form. You can usually find the health insurance claim form you need to submit by searching the insurance company's website. If your coverage is provided through your employer, you may be able to get a form from your human resources department.

2.

Complete the required information. Most of the information you need to complete on the claim form is fairly standard for forms of any kind, such as your name, address, and date of birth. You may have to complete a separate section of information for the patient if you were not the one who received the treatment. For employer-provided insurance, you will also need the name and address of your employer. Make sure you have your insurance card handy--you will need to include your identification or account number and those numbers are usually found on the insurance card. If you have additional health insurance coverage, such as through your spouse's employer, you will need the information regarding that policy, too.

3.

Take the form to your medical provider, if necessary. While you can complete a portion of the form, the remainder may need to be completed by the medical provider who was paid for the treatment. Because most of these medical offices require you to pay a fee to have them complete any form, you should be prepared to pay for that service, too.

4.

Submit an itemized bill of medical costs. Depending on your insurance company's form, your doctor's office may be required to provide this information on the claim form itself or you may need to submit the itemized bill along with the completed claim form. Be sure to read the instructions carefully so you submit the required materials; otherwise, your claim will be delayed or denied.

Tips and Warnings

  • Complete the form under the supervision of human resources personnel to ensure you are doing it correctly. They have experience with the forms and should know the most commonly made errors.
  • Keep a copy of the health insurance claim form and any other documentation you submit to the insurance company for your records. If a dispute arises about the payment, you need easy access to a copy of what you submitted.
  • Double-check the accuracy of the information you provide. Even a small error can cause lengthy delays and problems processing your request.
  • With most health insurance plans, you do not need to complete a health insurance claim form to receive coverage. Showing your insurance card is usually sufficient. For some types of health insurance, you may be required to pay upfront for the services then submit the form later to be reimbursed according to your policy benefits. To receive that reimbursement in a timely fashion, you need to complete the form completely and accurately.