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Tuesday, May 19, 2009

Cont Now It's Your Insurance Information

When was the last time you sat down with your other half and went over your insurance benefits.?? Bet never and it's been a very long time, I understand, really I do. For the best part of 30 years I have been an Insurance Verification Specialist at the 3 Hospitals I've worked for, it's a very complicated position, and you need to stay up on all the changes with hundreds of policies.
Here are some helpful tips to make your life so much easier when using your insurance.
1. Keep a current insurance card with you at all times, which includes all family members covered.
2. It's your responsibility to know what your out patient co pays are IE: ER visits, Radiology, out patient surgery, Lab (very important, do you have to go to a specific lab??)
3. Make very sure you obtain prior authorization for any/most out patient procedures, there are very few insurances that don't required prior authorization. Don't relie on the Physicians office to get the auth, you need to call the pre-certification phone number on that back of your insurance card to make sure the auth process has started.
I know of procedures that were done without the prior auth the procedure was denied, and the patient ended up being financially responsible for all charges. Trust me you do not want that kind of bill, oh no you don't.
4. Check your EOB (Explanation of Benefits) sent by the Insurance Co of total charges and what you will be financially responsible for.
5. If you are admitted to the hospital, make sure you check your itemized bill that all hospitals send to you. Do a line by line item check, highlight those charges you feel weren't done or you question. Call the Business Office of the medical facility you were admitted and discuss it with their rep's.
6. This is very important.....DO NOT TAKE PERSONAL BELONGINGS TO THE HOSPITAL... I can't be clear enough on this. It is not the Hospitals responsibility to keep track of your personal stuff, ER is different, the staff with put all your things in an envelope and they put in a safe until your are discharged. To avoid that, give all your stuff to a family member, things disappear in Hospitals folks, don't have the false sense of security just because it's a Hospital.
7. Last but not least, ASK questions I can't say it enough, ask questions for anything you or your family don't understand. The Medical Ind. today is a very complicated machine, it's even harder for our Senior Community to understand all the confusing roads one has to take today to get any thing done. Be a patient advocate for a family member or friend, one day we will all need that, so be prepared.
Let me know if you have any questions on the Medical Durable Power of Attorney, and the Insurance comment, I will be more than happy to help.
Ciao for now

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