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Claiming insurance benefits after a spinal cord injury-Part I

Residents of Louisiana's Calcasieu Parish would acknowledge that treatment and rehabilitation after a spinal cord injury often requires a considerable amount of money. For most patients and their families, the main source of funding is their medical insurance coverage. Sadly, obtaining this insurance is often a challenge because insurance companies tend to offer smaller payouts so that they are able to maximize their profits. As a result, the patient's difficulties are often increased instead of being resolved.

However, there are certain ways in which a spinal cord injury patient can resolve insurance-related issues effectively. First of all, the patient and the patient's family members should be aware of all of the benefits that are provided under the insurance policy. In addition to the covered expenses, it is also important to understand what is excluded from the policy. If the spinal cord injury is supposed to be covered by workers' compensation, it is important to understand all of the provisions of Louisiana's workers' compensation laws.

After understanding the insurance coverage and how it works, it is important to determine the identity of the case manager for a particular insurance claim. There may be cases in which the insurance company has not appointed a case manager; however, in such a case, the patient should ask for an immediate appointment. Once the case manager is assigned, patients and family members should explain the entire case so that the insurance company is fully aware of the spinal cord injury patient's necessities.

It is also important for patients and family members to understand the rehabilitation benefits that are covered by the insurance policy. For example, patients and family members should collect information pertaining to the number of days that are covered by the policy for inpatient acute and subacute rehabilitation, as well as for outpatient and home rehabilitation. One of the most important points upon which to seek clarification is the number of days that the insurance policy covers every year and over the course of the patient's lifetime.

Source: Shepherd Center, "Steps to Negotiate the Insurance Maze," accessed April 22, 2015

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