You need coverage for specific costs and decide to file a claim through the Employee Retirement Income Security Act of 1974 (ERISA). How long is it going to take to get that claim reviewed? You’re worried that you’ll be kept waiting for weeks or even months with no resolution.
The good news is that specific time limits have already been established by ERISA, so you can find out roughly how long it will take, giving you a window of time in which you can expect results. There are three different categories with their own limits, which are as follows:
- An urgent care claim. These claims should always get addressed within 72 hours, as technically, officials are supposed to do it as soon as possible.
- A pre-service claim. Though perhaps not as urgent as the above, this is still before the service is provided and so it makes sense that you want to know relatively quickly. Therefore, it should not take more than 15 days. The government notes that they strive to do it “within a reasonable time period,” so it could happen far faster than that.
- A post-service claim. The goal for officials here is twice as long as the above, giving them a maximum range of 30 days. Again, they should review all claims within a reasonable time period.
One important thing to note is that both holidays and weekends are included in these totals. They account for all calendar days, so you won’t see further delays.
If you have any questions about this process, make sure you know what steps to take to resolve them.