- First, get a copy of the insurance card and make sure you know what type of insurance you have. Is it a network only plan or do you have benefits that extend outside the network of providers?
- Identify the resources that are available to you to learn about your benefits. Members of the HR team where you have your insurance coverage should be happy to point you in the right direction. Be sure to ask if you have access to any advocacy benefits like Health Advocate.
- Confirm the provider is in-network. Even if someone at a doctor's office tells you that a provider is in-network, it's worth confirming. You should be able to look this up on your insurance company's website or confirm the information by calling the customer care number on your insurance card.
- Find out if you need to notify the insurance company before receiving any services. In general, Network providers are responsible for notifying the insurance company before providing certain services. However, there are some services that you may need to notify the insurance company about even if you use a network provider. These may include things like -- non-emergency ambulance services, participation in clinical trials, dental services received as a result of an accident, and transplants. If you use an out-of-network provider, you are likely to be responsible for obtaining approval yourself. To notify the insurance company, call the customer care number on your insurance card.
- Call your doctor for test results. Most patients assume no news is good news if they don't hear back from their doctor about test results, but this can be a mistake. An article in the New York Times reported on a study that showed that 25% of the time there was a problem getting the results back from the lab and 7 percent of the mistakes involved the doctor's office failing to notify patients of the results. So, be sure to ask these questions. (1) Will my test results be sent to the doctor? (2) When should they receive them? And, then follow-up if you don't get a call when you expect to receive one.
- Consider getting a second opinion. This article suggests a second opinion can help save you money, help you feel more comfortable, verify necessary treatment, confirm diagnosis, and present other treatment options. If you're consulting with another provider, ask what test results you should bring with you.
- If you're scheduling surgery, ask if you need to preregister at the hospital or surgery center before the procedure.
Thursday, February 9, 2012
Seven Questions Caregivers Need to Ask
In most families, one person takes on the role of coordinating health care and insurance coverage. According to the Department of Labor, "Women make approximately 80 percent of health care decisions for their families and are more likely to be the care givers when a family member falls ill." So, what happens when the decision-maker is ill? Here are some things you need to consider if you suddenly find yourself taking on the caregiving role.