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How Our Insurance Claim Management Works

senior couple sitting on a bench laughingFinding a high-quality in-home care service is hard enough without financial concerns hanging overhead like a dark cloud. Now that you’ve found the compassionate, experienced team at Premier Personal Care, it’s time to understand your options for payment assistance and how to gauge financial responsibility. Here’s how insurance claim management can help you navigate costs associated with Premier Personal Care so you or your loved one can get the help they need as easily and as stress-free as possible.

Basic Policy Reviews

It all starts with a basic review of your existing insurance policies. Understanding your coverage isn’t always easy, but it’s worth digging into the fine print and getting to know your benefits. You give us the contact information and relevant details, and we’ll do the legwork. At the end of our research, you’ll have a clearer picture as to the extent of your coverage — and you may be pleasantly surprised!

Documentation

Many insurance providers require proof that certain services are necessary. For instance, if you or a loved one needs help with activities of daily living, it’s beneficial to have a physician sign off on any disabilities or put care recommendations into writing. We can also help document the services Premier Personal Care provides, including keeping detailed logs of who provides the service, what each visit entailed, and when those services were performed. 

Sometimes insurance companies will send their own assessor to gauge the insured person’s needs, or they may choose to make an assessment by phone. Premier Personal Care can help ensure accurate information; in addition to the logs referenced above, we can prove our qualifications as an eligible provider (when applicable) and add our own assessment of your needs to support your coverage request.

Addressing Your Unique Needs

Premier Personal Care offers a wide range of services including assistance with personal tasks like using the bathroom, dressing, and eating as well as items from the household to-do list, such as pet care and cleaning the kitchen. In-home care workers can even be on the lookout for potential trip hazards and rearrange furniture accordingly. We’ll help you find out not only which services you need, but which might be covered by your insurance and how to apply.

Activating A Long-Term Care Insurance Claim

If you have a private policy in place that offers financial coverage for long-term care, there may still be quite a few hoops to jump through before you can access your benefits. We’ll help you find out whether there’s a waiting period before you can utilize coverage, whether there’s a cap you should be aware of, and if there are limits to what you can use your policy to pay for.

Medicaid Waivers

Did you know….? Premier Personal Care is an approved Medicaid Waiver agency. That means many of our services are eligible for Medicaid coverage, assuming you qualify according to Medicaid’s existing criteria. Applicable waivers include:;

  • Aging Waivers: Home- and community-based services for qualified persons 60 years of age and older
  • Attendant Care Waivers: Services and support for adults aged 18 to 59 who have a physical disability
  • Independence Waivers: Home- and community-based services for individuals 18 to 60 who have physical disabilities that limit independent living but no intellectual disabilities or major mental disorders
  • OBRA Waivers: Home- and community-based support services for adults with developmental physical disabilities that would otherwise require placement at an intermediate care-level facility
  • OMMCARE Waivers: Home- and community-based services for adults over the age of 21 who have been diagnosed with a traumatic brain injury

If you’re interested in seeing whether you qualify for Medicaid Waivers, you can contact the appropriate Bucks County agencies or talk with our office for additional guidance.

Get Help With Insurance Claim Management Today

If you’re considering in-home care and want to know what insurance benefits are available to you before signing on the dotted line, Premier Personal Care is here to help. Reach out to our team to find out more about our services, schedule a meeting, or see how we can pave the way for greater independence and fewer financial stressors.

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