Hospital stays, pre-op preparation, post-op care…there is a lot to consider when facing an upcoming medical procedure. But have you prepared your financial game plan?
A new study says that medical bills cause financial troubles for more than 2.2 million Americans each year, and they account for about half of all U.S. bankruptcy filings*. Preparing financially for an upcoming procedure can be a big job. Human nature allows us to prioritize health and wellbeing far above financial ramifications of a situation. Insurance and billing is often perceived as confusing but it doesn’t need to be.
First, get educated! Find out what your insurance plan covers and what it does not. This may mean dusting off that inch thick manual you received when your coverage started and reading it. Let’s face it, insurance policy manuals are technical and wordy, I often struggle to make sense of them let alone stay awake while I muddle through medical jargon. Keeping a notepad handy will allow you to write down questions as you read through your coverage, providers etc. Noting deductible amounts, out-of-pocket caps and non-covered procedures is a good place to start to get the core structure of your coverage.
You will also want to educate yourself about the procedure you are having done. Know the medical name for it and if possible get a diagnostic or billing code from the Doctor so you know exactly what you will be billed for.
Second, get answers! Now that you have a basic understanding of how you’re covered, I bet you have questions. Call your Insurance provider; usually a customer service number is on your card. Be prepared to wait! I have yet to interact with an insurance company who has lightning fast customer service. I usually plan on a good deal of automated responses and hold time before I get a live person (I can fold a few loads of laundry or read a couple chapters in my book) Arm yourself with a notepad and pencil ahead of time, when you get to a customer service representative do the following:
- Note the day and time you made the call
- Note their name or worker ID number for reference (I have needed this on several occasions)
- Take notes as they respond to your questions. Ask specific questions about your procedure, if you have the billing code you should be able to get exact coverage specifics for that procedure. I often write my questions out in advance and leave spacing for their response.
Third, get reassurance! Many times insurance companies will need preauthorization or referrals for a procedure. Make sure all of the formalities are covered. It is often assumed a Doctors office will take care of preauthorization and proper referrals but ultimately you should manage this. If it is the doctor’s responsibility to preauthorize, get confirmation that it was done. Again detailed notes of whom you spoke to and what they confirmed are a good idea.
I also like to repeat my call to the insurance company to double check what I was told on the first call. I know this is daunting but if customer service rep. A tells you something different than customer service rep. B it is wise to know this BEFORE the procedure is performed.
I learned much of this the hard way and that is expensive! My son has had several major procedures and each one taught me a little more about being prepared financially ahead of time. I sometime view each surgery as a tiny battle with the insurance company, and I never want to walk into battle ill prepared. I remember once we had a conflict with the insurance company after my son’s bone graft surgery, it would have cost us thousands but my diligent note taking and preparedness saved the day. Often times I felt embarrassed by badgering the customer service rep’s with the same questions over and over but it is worth it in the end.
I encourage you to get prepared and proactive beforehand and it will allow you more time to concentrate on a healthy recovery later.
* Source: http://www.naturalnews.com/004318.html
