One of our many Medicare patients called recently to ask about what SECONDARY policy to sign on to. As it is not appropriate for us to tell them which policy to select, we tell our patients which plans we have participation in and advise them to make sure the plan they select meets their health [...]
We have seen a surge of refund requests from many insurance companies. These are coming to us from one month after the claim is paid to almost 2 years after the claim has been settled. These refund requests have gotten more frequent now with the economic downturn. If you pay close attention you will see [...]
As we have expected, copays are now being applied to services which did not require one in the recent past. We all know that all insurance policies are getting more expensive and providing very limited benefits. To make these policies more affordable, insurance companies are passing the service costs to you, the patient. Lower monthly [...]
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Within the past year, we have seen many patients with new insurance policies. New insurance policies raise the question of WAITING PERIODS and PRE-EXISITING CONDITIONS. These two terms have become the bread and butter of our Billing Office for the past several months.
What do those terms mean? First, lets discuss WAITING PERIODS. These represent time [...]
Following our understanding of DEDUCTIBLES, we also need to understand CO-INSURANCE and CO-PAY. These last two terms imply a shared responsibility. As we have mentioned before, being insured means more than having someone else pay for medical expenses. In this note we will explain the CO- in CO-INSURANCE and CO-PAY.
CO-PAY is a [...]
Deductibles are patient responsibility amounts set by your insurance company. Deductibles are portions of your claims which are not paid by your insurance even though they are approved services. The most basic setup is a yearly deductible. Aside from this, some insurance have a deductible per diagnosis. Invoiced services have to be assigned to the [...]
We have been presented with the comment, “I am fully insured, why did i get a bill?” over and over again. This particular statement comes from not properly understanding an insurance policy and its related responsibilities.
As health care providers it is our duty to provide our patients with the care they need. This [...]
We are putting together some thoughts related to our services as well as some ideas from our Doctor’s. Items discussed here will be related to how to better understand your care and manage your insurance benefits. Keep visiting as these will be posted regularly.
Please note that no personal information or data will be discussed or [...]