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E-Articles - What You Should Know about Health Insurance Claims
If you have been hurt or injured and have to receive medical services, and you have medical insur
According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product
ance, it might be beneficial to understand how a health insurance claim is processed.
Each healt
Each healt
; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.
Examples of combination products may in
Examples of combination products may in
insurance company has its own set of policies and procedures. If you have a large claim, you wil
lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.
want to review the rules especially carefully. Many claims are denied over a simple technicality
here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
Knowing the process is likely to help you make sure your claim does not get denied.
Most people
Most people
d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.
Combination pro
Combination pro
assume that when they receive medical services all they have to do is present their insurance car
ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc
and then never worry about it again. Oftentimes that is not the case. The first thing you want t
easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi
check is if the medical services you are receiving are pre-approved by your insurance company. T
nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
is differs greatly from company to company. An easy way to find out is by calling the customer se
and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ
vice number provided with your insurance cards. If something is pre-approved, then generally fili
ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
g a claim will be easy.
Remember, insurance companies are hoping that you will not need medical
Remember, insurance companies are hoping that you will not need medical
ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.
Following aspects would a
Following aspects would a
ervices. That is how they make their money. If you don't use your insurance, the insurance compan
dd to the challenges in developing combination products:
Which markets to tap where the combination products can do fairly well?
Which combination prod
Which markets to tap where the combination products can do fairly well?
Which combination prod
just gets to keep it. You will notice that the bigger the claim, the more paperwork you will nee
cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
to fill out and the more red tape you will need to wade through.
If you receive medical service
If you receive medical service
tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
that should be covered by your insurance, make sure that the doctor or hospital file the appropr
t?
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
ate forms. Make sure that you file any forms that you need to in a timely manner. If you have any
ping new procedures for reviewing their safety, efficacy and quality.
Professional from academic institutions, pharmaceutical industries, health care indust
Professional from academic institutions, pharmaceutical industries, health care indust
questions, call the insurance company directly and find out the answer. Make notes of who you spe
y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
k to and when.
Once your claim is received by the insurance company, they will try to determine
Once your claim is received by the insurance company, they will try to determine
.
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
f there is a reason they can get out of paying for your medical services. If your claim is justif
elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.
Companies that provide selfless information through particip
Companies that provide selfless information through particip
ed, then you can expect payment to be made. Usually it is done directly to the hospital or doctor
tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products
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