When looking for a new doctor, there are 4 questions that matter the most: • Is the doctor covered in-network by my insurance? • Is the doctor well trained and experienced? • Will the doctor be available when needed? • Will the doctor work in partnership with me? Insurance To ensure you receive the maximum [...]
Coodination of Benefits…what does that mean?
Coordination of benefits is used when someone is insured under more than one insurance plan. It is a process of paying insurance claims that ensures they are not paid multiple times. The idea behind coordination of benefits is to give insured individuals as much coverage as possible while at the same time eliminating over payment. [...]
Medical Bill Charges: Understand them before you pay
Regardless of your medical bill amount, it should be reviewed carefully Be sure your medical bill does not contain services you did not receive. Pay attention to details. You are entitled to an itemized bill whether you have insurance or not. An itemized medical bill details each procedure and/or service you had during your visit. [...]
What is the Difference Between PPO and HMO Insurance?
Overview Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are two common types of managed care health insurance plans. There are similarities between the two plans, for instance, they both cover a variety of medical, surgical and hospital services and some also include coverage for prescription drugs. However it is important to know the [...]
When being a bad patient is good.
There are some scary statistics out there: • When you see the doctor, the diagnosis will be wrong as many as one out of four times, according to a report by the Agency for Healthcare Research and Quality. • One out of 14 times you have an abnormal test result, doctors will fail to let [...]
San Diego Reader | That's ok, sir, I am authorized to offer a 50% discount
An excellent, article appeared in the San Diego Reader by Chad Deal on Wednesday, July 7, 2010 (http://www.sandiegoreader.com/news/2010/jul/07/cover/) Key points everyone needs to be aware of: When choosing a hospital, get a quote on your visit from the hospital’s billing department Research fair prices ahead of time. www.healthcarebluebook.com Ask what the room price includes, bring [...]
Medical insurance fraud
Medical insurance fraud is committed in a number of ways. For instance, when a consumer files a claim for services or prescription drug he never received or a provider bills for a service it never actually provided, a crime has been committed. Anytime a consumer or provider knowingly presents to her insurance company false information [...]
How can insurance dictate your medication?
Overview A common feature of all insurance plans whether it’s Medicare, a group or an individual policy is to regulate the prescription drugs prescribed for its members. This is done in four ways: requiring a prior authorization, step therapy, maximum dispensing limits or excluding certain medications from its prescription drug list. Prior Authorization Some drugs [...]
Report Medical Insurance Fraud
Medical insurance fraud is committed in a number of ways. For instance, when a consumer files a claim for services or prescription drug he never received or a provider bills for a service it never actually provided, a crime has been committed. Anytime a consumer or provider knowingly presents to her insurance company false information [...]
Do you have a medical proxy appointed?
A medical proxy is also known as a health-care proxy or medical power of attorney. It is a legal agreement where you appoint someone to make decisions on your behalf if you become unable to make a medical decision for yourself. Why Do I Need One? There are two situations when a medical proxy is [...]
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