Insurance Harvest Time

—Oct 06, 2008

Fall is here and marks the end of the harvesting season. The nights are getting longer and colder. It won’t be long before the first frost of the season arrives. When that happens, the veggies left out on the vine won’t be worth picking.

It’s also insurance benefit harvest time. For most people insurance benefits reset in January. If you have a deductible, you have to start paying again before the insurance company does. If you have a medical savings account and didn’t use all those dollars, they vanish on New Year’s eve at the stroke of midnight. Now is the time to make use of your 2008 insurance benefits. Once Halloween arrives, we blink and it’s time to ring in the New Year. If you need care and you still have insurance benefits, now is the time to make plans to use them.

And don’t forget to plan for next year. As I mentioned earlier, for the vast majority of people, the insurance clock resets on January 1st. A lot can happen between New Year’s Eve and New Year’s Day. Deductibles can appear out of nowhere, co-payments can double, benefits can be slashed. If you have a choice of plans through your workplace, take the time to review the benefits now. There’s only one way to do that right…read your policy. That’s the best way to make sure your health care garden keeps you covered next year.

— Richard Fink, DC, FIAMA

Filed under Insurance

Click here to subscribe to the Wellness Wave blog.

Insurance Blues

—Mar 23, 2008

Well we are two and a half months into the new year and a pattern is clearly emerging. Sadly, it is a pattern of insurance companies finding new ways to pay less while squeezing patients for ever increasing premiums.

There is always a lot of confusion about insurance coverage. Patients receive new insurance cards in December or January that are identical to their old cards. They even have the same member ID number. But buried in the benefits booklet that comes with them is the real story.

Some patients now have deductibles when they never had them before. Others have seen their co-payments double. Still others have carriers refusing to pay for types of treatment this year that were paid last year.

Because of this, patients may find that they have a balance due on their next visit even though they paid their last copay. If this has happened to you, I want to make one thing clear. Our billing hasn’t changed. The insurance coverage has.

That’s why it is important to read your copy of the Explanation of Benefits that comes in the mail. As far as coverage goes, a call to your insurance company goes a long way to understanding your benefits. You see, even though we make every attempt to verify your benefits, Fink Family Wellness does not have a contractual relationship with the insurance carrier. The patient does. It is his or her policy. Many times a call from the patient will get the insurance company to pay a bill that they initially denied.

How is it possible for an insurance company to tell us the patient has coverage and then not pay for care? It’s simple. Call any carrier and ask to verify coverage. Before you get a human on the line a recording informs you,”Verification of benefits is not a guarantee of coverage.”

It’s all part of the insurance game. The only way to make sure your insurer is playing by the rules is to get involved. In the long run, that will save you both aggravation and money.

— Richard Fink, DC, FIAMA

Filed under Insurance

Click here to subscribe to the Wellness Wave blog.