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The main types of health and disability claims

When you make a health and disability benefits claim, there are specific time limits for how long it can take for the claim to be evaluated. These are different depending on the type of claim, which could be one of the following:

— Group health claims. When a group claim is made, it will be either a post-service claim, a pre-service claim or an urgent care claim. This is just the umbrella term for those listed below.

— Urgent care claims. These are technically pre-service claims, but decisions are made more quickly than usual. Typically, an urgent claim revolves around a situation where you could be in serious danger—of either death or serious health complications—if you wait.

— Pre-service claims. A standard pre-service claim has to be put in prior to medical care. Often, the goal here is to decide if the procedure in question is truly necessary. You are not in any urgent danger, so the procedure has to be signed off on to make sure doing it really makes sense, rather than rushing into something that doesn’t have to be done.

Post-service claims. As the name implies, these are claims made after care has been given, often under a group health plan. When you put these in, you are typically asking for reimbursement for the costs. This category comprises the majority of the overall group claims.

— Disability claims. These claims focus on determining if the injury or ailment is severe enough that you are unable to work and are therefore disabled.

With any claim, it is incredibly important to know all of the proper steps to take to give it the best chance of acceptance in California. To learn more, please check out our site now.

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