STOP! Don't Pay!!!

We all want to pay our bills and behave as responsible adults, right? Of course we do. But take a moment to research the issue before you give up the cash. Here's why:

You're almost certain that your insurance plan covers, and therefore, should have paid for your doctor's visit. Yet, you have a bill from your doctor's office in hand, and there is no mention of your insurance plan's contribution to any part of the expense! 

"What the... ?" It's okay to panic for 2 seconds, but the next reaction should be a call to your insurance plan. Confirm that your visit is covered, and request the confirmation in writing. There is a possibility that your particular claim was submitted with errors, and subsequently denied. Instead of correcting and resubmitting the claim to your health plan for payment, perhaps it was easier to just forward the bill to YOU!

Save yourself some grief by becoming very familiar with your health plan's EOB or Explanation of Benefits; this document will usually state "This is not a bill," across the top of the page. An EOB will show dates of service, diagnoses, how each diagnosis was treated, AND the amount your doctor was paid. EOB's are your best friends, so keep track of them; BFF's for life! 

Besides, you've paid enough for the coverage you have! It's not your job to pay for someone else's errors, too ;-)

Don't be afraid to ask about their billing practices, and remember to come back and see me soon!

Thanks for stopping by!

Doctor Office Issues

How do you feel about your doctor's staff? How do you feel about your doctor?

I'm hoping your responses are positive and happy, but I'm not naive enough to expect it. The truth is, either your doctor's staff and/or you doctor is/are likely to cause you negative feelings. (Sorry to be the bearer of bad news).

But, I love my doctor! What could possibly cause me to feel negatively about my doctor? Here are a few potential examples:

1) Difficulty communicating with staff;

2) Unable to reach a live person via their 24-hour on-call service;

3) Failure to follow your insurance plan's protocol, resulting in your inability to receive your prescriptions; 

4) Broken promises to call in your prescription to a pharmacy; or

5) Doctor's failure to answer your questions and/or provide you with the resources necessary to improve your medical condition; just to name a few.

Chances are you (or your child/loved one) are probably not feeling well. So, the last thing you need is for processes to run in inefficiently. So what are you going to do? Complaining is useless, unless you are willing to actually do something about it. Things you CAN DO:

1) Take advantage of your time and Express your concerns directly to your doctor;

2) If things don't change, write a letter to your insurance plan, explaining your concerns;

3) Shop around for another doctor/healthcare provider;

4) It doesn't matter if your health insurance plan is Medicaid, Medicare, Tricare, Aetna, Cigna, etc.;

5) Always remember, IT'S YOUR DIME FOR THEIR TIME. Your doctor owes you appropriate service.

NOW, GO GET IT!!!
...and come back to see me, soon!

Before you go...

Just a quick reminder for everyone to check their insurance plans prior to visits to the doctor and pharmacy.  Failure to do so could result in a lengthy conversation over the amount owed!  Therefore, insurance plan documentation should be kept in a safe, but accessible location.  Having knowledge of copay/coinsurance amounts helps minimize the element of surprise, once it's time to pay up ;-)

Another tip that can help ease the flow of visits to the doctor and pharmacy include access to the most current formulary or menu of drugs for each insurance company.  Patients should take a copy of the most recent version of their insurance company's formulary with them to doctor's appointments.  That way, when the physician or health care provider chooses a medication regimen, both the patient and physician can discuss the best options for the patient.

When physicians are made aware of medications covered by insurance, they are better equipped to help patients meet their medical needs.  In turn, patients' knowledge of their insurance coverage can make for a more successful pharmacy visit, too!

 In other words, make sure your physician is writing prescriptions for you that ARE covered by your insurance plan.  Otherwise, expect a delay at the pharmacy and an overall more expensive price on your prescription label ;-)

Then, you may go on, more efficiently, about your day!