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.
