Dealing with Insurance Companies

Dealing with Insurance Companies 
 
Having a child in the NICU brings with it so many emotions and 
realities, and often times one of the most stressful ones has to do with 
medical insurance. It won’t be long before the bills and phone calls 
start pouring in, and while this is the last thing any new parent has 
time or energy to deal with, it’s best to be prepared. Here are some 
tips that might be helpful: 
 
 The first thing to do is to find your copy of your health 
benefits book from your insurance company and start reading 
it over. You most likely would have gotten this when you first 
enrolled in your insurance plan, and sometimes a new one is 
given each year with any updates and changes. Find it and 
start looking at the specific sections dealing with 
hospitalization charges, specialists, and in network versus out 
of network charges. You will also most likely have a short 
window to contact your insurance provider or employer to add 
your new baby as a dependent. This must be done to be sure 
they have coverage under your plan. 
 
- Contact someone in the hospital’s billing department. They can 
 tell you if they accept your insurance and what your estimated 
 co-pays or out of pocket costs might be for the first couple of 
 days. Sometimes the NICU social worker also helps in this 
 area—be sure to ask. 
 
- Start a folder right away labeled with your child’s name and 
birth date, and keep ALL receipts, notes, forms, and bills in 
this same folder. This keeps everything together in one place. 
As a new parent and a NICU parent, your stress level will be 
high. Don’t add to it by misplacing important papers or forms. 
Make sure everyone dealing with the insurance knows that all 
forms go in the folder—it will save lots of headaches down the 
road. 
 
- Keep detailed notes. Whenever you talk to someone about a 
bill or statement, write down a quick summary of what was 
discussed. You can do this right on the bill if there is room, or 
attach another sheet of paper if that works better. Include the 
name of the person you talked to, the date and time of your 
call, and a brief summary of what was discussed. This will be 
helpful if later on you have to talk to someone else about the 
same issue.

-Once the bills start really coming in—don’t stress yourself out by 
looking them over every day. Just open them, put them in your 
folder, and designate one day a week to look over them. Nothing 
is going to change in a week’s time, and by setting aside that 
specific time each week, you spare yourself a lot of worry and 
anxiety over each day’s mail. 

-If you are having trouble paying the bills or not getting what you 
need, see if your hospital or insurance provider has a medical 
billing advocate that you can talk to.

-Know your insurance company’s appeal process. Sometimes this 
information is printed right on the bottom or back of bills, if not; 
check your health benefits book again. If you think a charge is 
denied and it shouldn’t be, you will have to file an appeal. Often 
time these are a lot of work—but it is necessary if you think 
something isn’t being paid that should be. You may also need to 
get detailed medical records on certain conditions or letters from 
healthcare professionals like doctors—don’t be shy about asking 
for these. In this day and age, doctors are well aware of the 
difficulties found in some insurance policies and most likely will 
work with you to try and get any issue you may have resolved.

-Lastly, find out if you qualify for any state or federal programs. 
Often, the NCU social worker or discharge planner can handle 
this. Each state has different criteria and regulations, but you 
should check to see if your child is eligible for Social Security 
Income, Medicaid/Medicare, WIC, or any other programs.