The US healthcare system

Why do I have difficulty getting a doctor to accept my insurance?

  • US healthcare providers are not required to accept your insurance.
  • One of the first questions you are probably asked when you call to make an appointment with a doctor is – ”Who is your insurance?”
    • If you say only that it is with the government you may encounter difficulty, as most providers have a policy that they do not bill foreign insurance.
    • If you say Equian, this may be of no immediate help either, as Equian is relatively small and not nationally known – the provider will may never have heard of us.
    • You will want to tell the provider that your insurance is Equian, but identify the provider network as well. Please contact our office if you are unaware of the network name.
  • US healthcare providers are accustomed to patients being required to utilize only providers in the insurance network; they may be assuming that if they are not part of your insurance network they will not be paid.

Choosing a physician who will accept your insurance

  • You select any doctor/hospital, however the healthcare provider is not required to accept your insurance.
    • If the doctor does not accept your insurance they will likely expect payment from you at the time of your visit.
      • You will be reimbursed by Equian for this.
  • The best way to ensure a doctor will bill Equian is to use a doctor from our Preferred Provider (PPO) network.
  • What is a PPO?
    • A PPO is a group of hospitals, physicians and other healthcare providers who agree to provide health care services at pre-negotiated rates to plan participants.
      • Healthcare providers join an individual PPO in order to have patients directed to their offices/facilities.
    • Why are PPOs important to you?
  • Healthcare providers a required to accept patients who are part of a PPO they participate with (so long as their practice is accepting new patients); you should not have any problems with the healthcare provider billing Equian directly.

What happens at the doctor’s office/hospital?

  • When you register/sign-in a member of the provider’s staff representative will ask you for your insurance card.
    • If the representative questions the insurance it may be necessary to point out again the name of the provider network.
    • The provider’s representative may call Equian to confirm your coverage and/or obtain coverage details.
  • They may ask you to pay your share of the services, if any.

What if I am required to pay the bill in full?

  • Ask the provider for a bill for your insurance
  • They are aware of what form/information we need
    • The bill will show the patient’s name, diagnosis, date of service, each service(s) provided, and the fee for each service.
  • Send the original of the bill to Equian
  • Make sure the bill is marked that it is paid
    • This can be done by you
  • Equian will mail a check to you
  • Our target turn-a-round time is 8 days

Why do I receive bills?

  • In the US medical bills are ultimately the patient’s responsibility to pay.
    • Insurance is billed as a ”courtesy” to the patient.
  • You may continue to receive a bill until the provider has posted our payment to the account.

What if I need a prescription?

  • You must pay for the prescription and send the prescription receipt to Equian for reimbursement.
  • Pharmacies only send bills to insurance electronically.

HELFO Members - How it Works

Equian is the administrator in the United States chosen by the National Office for Social Insurance Abroad, HELFO, to handle insurance matters for its members.

We are here to be your total resource for assistance with any issue relating to your healthcare experience; examples include but are certainly not limited to:

  • Assistance finding a healthcare provider who will accept your insurance
  • Contacting providers to attempt to get them to bill Equian
  • Questions about billing statements you receive in the mail
  • Questions about what is covered and what is not
  • Questions about what you owe
  • Assistance with completion of insurance waiver forms

Equian pays your medical bills, or reimburses you for medical expenses paid, within the guidelines of the Norwegian Insurance Scheme.

  • HELFO provides guidelines as to how and what to pay
  • HELFO is advised each week of each bill that is to be paid
  • HELFO confirms calculations made on amounts to be paid
  • HELFO makes all decisions on appeals

Frequently Asked Questions

We have compiled a list of frequently asked questions by HELFO members.  Please click here to see a list of those questions with answers.  If you still need assistance, you may email helfo@equian.com for further assistance.

Update Address

To update your address with Equian, please click here to fill out a short form.  A representative will handle your request promptly.  Please be sure to fill out the form completely.

Insurance Card Registration

To register for an insurance card with Equian, please click here to fill out a short form.  A representative will handle your request promptly.  Please be sure to fill out the form completely.

Status of a Claim

To check the status of a claim, please click here to fill out a short form.  A representative will handle your request promptly.  Please be sure to fill out the form completely.  You may also call us toll free at (800) 962-6831 during normal business hours.