Know Your Healthcare Plan

When people go to buy a car, they know exactly what they're paying for. They know the year, the model, how big the engine is, and most certainly how many miles they have to go before the warranty runs out.

It's not the same when people purchase a healthcare policy. Yes, they may know their deductible and co-pay, whether or not they have out of network benefits. But rarely do they know things like whether or not a DME or Orthotic falls under their usual deductible or if it falls under a completely separate deductible. By the way, most of the time DME products do fall under a separate deductible.

When it comes to health insurance even the most highly educated are at a loss of what their healthcare pays and doesn't pay. That's understandable since those that work with healthcare claims every day struggle to keep up.

Become educated about what you're paying premiums for every month. You probably know what you're spending your money on in every other aspect of your life -- your healthcare shouldn't be any different just because it's complicated.

If you don't know what your policy covers, how in the world do you know whether or not you're being billed for something you shouldn't be? You don't! If you don't know what your policy should cover and at what percentage, how can you argue when you're billed the wrong amount? You can't!

Your best weapon in getting your claims paid is to know your policy inside and out. In the long run, knowing what you're paying for every month will help you avoid paying for something you shouldn't be paying for.

Why Patients Need A Guidebook!

I've written a guidebook for patients on how to get their health care claims paid that as of yet is unpublished due to lack of interest by agents and publishers. Yet it never fails on a weekly basis I'm constantly pulled into conversations about claims that aren't getting paid or patients that are not being billed correctly, not to mention it's one of the hottest topics on the horizon with all the changes coming up. It's obvious there's a need for a guidebook or at least some helpful information for patients so that's why I started this blog. To share the experience and knowledge I've learned over the years and am continuing to learn on a daily basis!

When you mention health insurance to most people, their eyes glaze over. It's just too complicated. Well, guess what? It's complicated for those like myself that deal with it on a daily basis! Not only do we have to keep up with all the insurance company's legal jargon that changes practically every day, but we also have to be part lawyer, part doctor, and part IT Specialist just to navigate the medical billing process.

If those of us in the industry have to be all of these things, then how does a patient that's on the outside without any inside knowledge know how to navigate the medical billing world when there's a problem? They don't. They have to learn through trial and error regardless how they feel, or they just pay the darn bill they don't owe because they're tired of making phone calls and trying to figure it out.

So in the months to come, my plan is to keep writing and sharing my experience to maybe help someone else. There will probably be a little venting thrown in there too from time to time! Stay tuned -- we all may learn something!