Eye Care & Surgery Center NJ Bladeless LASIK Laser Cataract Surgeon Blog

Friday, June 17, 2011

Medical Insurance – What to Know?

In today’s world of big insurance companies and small employer groups, understanding your health benefits can be a tough task. I think most of us can agree that deductibles, co-pays and premiums are higher than they have ever been. In order for employers and insurance companies to save money, out of pocket expenses have been passed on to the policy holder.

It is important for patients to understand that their insurance policy is an agreement between the patient and their insurance carrier.

Call them and ask the questions you would like the answers to:

Is the doctor I’m seeing in network?
Do I have any type of deductible?
Do I need a referral for a specialist?
Is this a covered benefit?

These questions can help you avoid unexpected out of pocket expenses. They can also help you utilize your insurance coverage to ensure you get the most from your benefit package. The call should not take too much of your time and it may save you lot of aggravation in the future. Insurance companies have made it easy for patients to find out their coverage. There should be a member services phone number on your insurance card. Ask for the benefit department and they should be able to review your individual policy and give you the answers you are looking for.

From a physician’s office point of view, practices have patients coming in and out all day and see many different insurance cards. They cannot possibly know or be held accountable for every patient’s individual insurance benefits.

A physician’s office will usually submit a claim on your behalf but at the end of the day the patient is the person that will be held accountable for any outstanding balances and non covered services. Make the call, know your insurance and be your own advocate. In the long run you will be glad you did.

Thank you to Judy McCann, Director of Billing at The Eye Care & Surgery Center, our guest blogger today, for sharing her insights and knowledge with us.