How to Choose an Insurance Company

For Medical Insurance

How do you choose an insurance company who will deliver your health care services, now that you have narrowed down the type of policy you would like, the benefits you are interested in, and the providers you feel comfortable with?

Check with your State to insure that the company you are considering meets your State's regulatory requirements. You can do this by contacting the Department of Insurance for your particular state. You should also check with the Better Business Bureau to see if there are any charges against the company you are considering.

You should choose an insurance company that is accredited by URAC. The nonprofit organization known as URAC (Utilization Review Accreditation Commission) was established in 1990. Initially, the organization only reviewed medical insurance providers in a few areas, such as credentialing and case management.

Over the years, URAC has expanded. URAC now provides accreditation in 15 areas with more areas being added each year. Areas of accreditation now include client safety, review of health plans, customer support, disease management, drug therapies and more!

Every three years, URAC reviews and revises its accreditation requirements. Although not all states have stepped up to require URAC accreditation of all medical insurance companies and plans, those that do require URAC accreditation accept it as meeting the state’s regulatory requirements.

Not all insurance carriers will request URAC accreditation, and, those that do request URAC evaluation do not have to request reviews in all areas. Allow me to explain.

You may find the insurance provider you are interested in proudly boasting their URAC accreditation record "URAC ACCREDITED SINCE 1997!" But, when you go to www.URAC.org you may find that the company sought to be accredited only in the area of case management. They may not be accredited in the areas of credentialing (the area that insures its healthcare providers hold the proper licensing to practice, and do not have any lawsuits pending against them), customer service or any of the many other areas URAC is able to provide accreditation.

Trust me, it is very very difficult to become URAC accredited and companies who are accredited should be very proud of their accomplishments. But, in saying this, I would have to challenge all insurance carriers and health plans to seek URAC accreditation in all areas!!!!!!

By going onto their website, you can find out if the provider you are interested in has been accredited by URAC and what areas they have received their accreditation. It is my humble opinion that companies that are willing to go the extra mile to become URAC accredited are worth considering as you choose an insurance company.

Your current physician and his/her billing department can also provide you some very interesting feedback regarding the various medical insurance companies. Some companies are very difficult to work with, and slow to provide authorizations and payments.

With so many resources available to you, it is easy to choose an insurance company who will meet your needs!

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