Sink Holes to avoid when choosing a doctor or dentist.
Finding a good health care provider in your area that takes your insurance is easy but there are some sink holes that you will want to avoid to ensure a smooth and painless (financially anyway) visit. I call them sink holes because before you know it, it is too late; you are sunk and now in a financial hole. What just happened? I have insurance, I asked if they took my insurance and they said yes, but now the insurance company says the provider I saw is out of network and if I fill out this claim form I can get $31.03 back on this visit that just cost me $157? Sound familiar? How does that make sense?
As a health insurance professional, I am the marketing and service arm that stands in between the health insurance companies and you the consumer. In this position I have many roles and responsibilities to fulfill on both sides of the business however; the role I enjoy most is that of consumer advocate – helping individuals understand their health, dental and/or vision plan.
Helping consumers understand the plan and benefits they currently have is only a small part of the process. As you know, when it comes down to actually using your plan and receiving the benefits, things can be quite different. This is the part (using your plan) that I want to highlight today as it is so critical to the experience or outcome that will result. I put together a one page check list along with some terms that you will need to know in order to stay out of trouble and on schedule. Choosing a good physician or dentist for the first time is never easy, but even if you do identify one that you think you would like to see, getting the services you need and getting the bill paid by the insurance company the way you expected them to pay it (as you understood according to the benefit schedule), is something equally as important when it comes to your over-all health care experience. There is no such thing as a GOOD surprise (generally speaking) when it comes to going to a new doctor or dentist for the first time. No surprises, only a stress free and predictable experience from beginning to end is all we really want, right?
So before you go to pick out a new doctor and/or dentist for the first time, before you schedule that first visit and go to your appointment, please take a look at my CHECK LIST and make sure you understand your plan benefits, especially the terms in the benefit schedule. Know exactly what they mean.
I hope you find this check list helpful as these are many of the things that I see over and over as a broker. If you have any questions, comments or suggestions, please feel free to comment to the blog or, Email me if you want and/or if you need help. Consumer education and training is one of the more valuable tools I can offer my clients or any consumer in need of help. Understanding how to purchase and be a smart consumer in health care is not only good for your pocket book, it is also good for your health and the over-all industry.
