Received a Questionnaire?

About The Rawlings Group

Who are we?

The Rawlings Group has served health plans across the nation since 1985.  As a trusted business partner of your insurance carrier, we help to reduce costs and ensure that claims are paid correctly.

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Frequently Asked Questions

1. Why did I receive a letter asking about my medical treatment?
Your health plan has asked The Rawlings Group to review paid medical claims information and determine if another party may be financially responsible for resulting medical treatments. Your medical claims include certain treatment billing codes that are often related to an accident or injury. This may include events, such as an accident involving a motor vehicle, a slip and fall, injury on the job, medical malpractice, or defective product.

2. Should I be concerned if I don’t recognize the provider’s name on the letter I received?
No. The provider listed in the letter you received could be someone other than your physician. For example, this person could be an emergency room physician or radiologist who cared for you during your Date of Treatment period listed on the letter.

3. Do I need to respond, even if my treatment was not related to an accident?
Yes. Confirming that your treatment was not related to an accident is important information for your health plan to know.

4. What happens if I don’t respond?
Rawlings will continue to attempt to contact you as your health plan expects members to cooperate in resolving these questions. Depending upon the plan you have, your health insurer may pend claims until these questions are resolved.

5. How did Rawlings obtain my medical claims information?
Your health plan has contracted with The Rawlings Group to review medical claims that they have already paid to identify situations where another party may be responsible to pay those claims. By contract, The Rawlings Group is authorized to perform this service for the health plan, and complies with all legal requirements including the Health Insurance Portability and Accountability Act (HIPAA) and your health plan’s requirements for handling your protected health information.

6. What should I do if I experience a technology issue and cannot complete the questionnaire?
Please call the toll-free number listed on the questionnaire that was mailed to you. A representative dedicated to your insurance carrier will be available Monday through Friday between 8:00AM and 8:00PM EST.