Questions To Ask Your Insurance Provider About Healthcare Billing
Wednesday, July 7th, 2010 by adminVisiting the doctor can be a stressful time. Add in the requirement that you need to stay abreast of any changes to your insurance, know your co-pays, your coverage, your deductibles-healthcare billing practices are a mystery to most. Here are a few questions to ask yourself even while obtaining your health insurance quote.
What is my Deductible?
Most patients aren’t aware of their deductible amount until it’s too late. CT scans or Physical Therapy may be one of the hundreds of services that require a deductible to be satisfied before one penny is paid from the benefits. The deductible on your healthcare insurance quote should not be confused with co-insurance. Ask your health insurance provider what is covered or check your coverage of benefits brochure to find out.
What is Co-insurance?
Co-insurance is a portion of the bill you will always be responsible for, regardless of your deductible’s payoff for the year, or the healthcare provider’s services rendered. Some services may even call for an additional percentage of the bill to fall on the patient. Sometimes seeking healthcare out of your network can raise the co-insurance you owe.
What is a Co-Pay?
A co-pay is a fixed amount you are responsible for, as long as all of your services are covered. For instance, you might have a $15.00 co-pay when you are sick and see your doctor. If you go to an Emergency Room, your co-pay may be different, say $50.00 a visit.
What are Non-Covered Services?
There may be a level of services that your health insurance provider does not cover, or that requires you pay a higher level of co-insurance. These fall under a general healthcare billing umbrella. For example, you find yourself admitted to the hospital. You have co-pay or co-insurance for the days you are admitted, but perhaps personal services such as meals, or personal care items are not covered.
What Does Out of Network Mean?
Many insurance companies require that doctors and healthcare providers enroll in their participation programs where they are subjected to regulation as the health insurance company sees fit. Depending on the level and type of health insurance you select, your network may be large or very small. What size network you need depends on any health conditions you may have and whether or not you live in a metropolitan area. It’s a very good idea to mention if you are reliant on durable medical equipment such as a wheelchair or brace, or it you have needs for medical equipment in the home. An example would be oxygen tanks for emphysema sufferers.
Whatever your needs, asking the right questions before requesting your health insurance quote can save you money and difficulties in the future.

