One piece of advice I always try and give my clients is to be proactive with their health insurance. Don’t be stuck after a procedure or surgery with an unexpected gigantic bill. Be proactive!!
Call and Ask Questions
Call the doctor’s office billing department, the hospital, or the surgery center and confirm with them that you’re in-network with your current insurance. Ask questions like:
- What will my total out-of-pocket expense be?
- What are my copays?
- Will this be applied to my deductible?
Get the Details in Writing
The best practice is to find out if the procedure will be applied to your deductible and coinsurance or if it will be copay only. Get into the details with the doctor’s office and facility about what your expected cost will be. I even recommend getting an email or something in writing you can fall back on if possible.
Negotiate
After researching the total out-of-pocket exposure, I recommend talking with the billing department and or doctors to see if they’ll negotiate any of the expense. People are always surprised at how providers and facilities are very much open to negotiating the out-of-pocket expense in specific situations.
Remember it’s a business, and the providers want customers coming to them for their treatments and procedures. Don’t sell yourself short as the customer.
How Being Proactive Can Help You
Being proactive with your health insurance can be beneficial, especially with my multi-tiered insurance plans. Many insurance plans have preferred or Tier 1 networks within the insurance network. Tiered networks allow the policyholder better benefits and less out-of-pocket cost when using that preferred or tier 1 network of doctors and hospitals. The challenge is when you come across a doctor or facility that is in-network but not in the preferred or tier 1 network.
Be proactive. Talk and see if the provider is willing to accept what the insurance pays them and not balance the bill you the difference. This can work and does work frequently. Today, many of the insurance plans use preferred, or tiered networks that can reduce patients for the non-preferred doctors and facilities and are open to working with the patient to have them as a customer.
The Bottom Line
As I said before, it’s a business, and doctors and hospitals still want new customers. So, the next time you’ve got a planned medical procedure, do yourself a favor and be proactive. Find out where you could save some money!
By Tom Brzezinski
Owner – William Michael Advisor Group LLC
Thomas M. Brzezinski is one of the founding partners of WMAG William & Michael Advisor Group LLC and Jersey Insurance Solutions. He has been involved in the insurance industry for over ten years and specializes in developing client relationships that last a lifetime.
