Friday, January 7, 2011

Savers Tip: Know Your Health Insurance

Health Insurance is a pretty hot topic right now in the U.S.A. and as a future physician I am naturally interested in it. However, this post isn't going to be about getting the right plan for you or my thoughts on national care and medicare. It's about something much simpler: knowing what your plan covers.

Many people assume the bills they receive in the mail have been properly processed and the remaining balance is all legitimate co-pays and deductibles. In an ideal world this would be true. But in the complex world of medical billing mistakes happen, and they happen often. Actually reading your bills and following up on why you are being charged can save you a lot of money.

I am a young, healthy, women and I just saved myself 175$ in health care bills. How? Some time ago I had a kidney stone. Not a big deal, this is a common health issue in young people who don't drink enough. To make sure everything was all right I went to see a urologist. I specifically picked a physician who accepted my health insurance to avoid out of network deductibles and fees. He was great. The 175$ bill I got in the mail a month later was not.

Most people would just assume this was normal and pay the bill. Most of my friends advised me to skip the hassle and just pay the bill. It's not like I couldn't afford it. But why should I be paying that much to see an in network doctor? It just didn't make sense. So I called the office. They explained that this was my out of network deductible. An out of network deductible for an in network physician? Something went wrong in the processing of this claim. So I had it resent to the insurance and today I was told that the bill has been taken care of.

Could I have just paid it? Sure. But that's $175 that I would never see again. So when you get a bill, make sure you understand it and do not hesitate to call your physician's office and insurance provider for clarification.


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