4 Things to Do Before You Receive Care
Healthcare is expensive; we get it. Our goal is to try to give you tips along the way that will help you keep as much of your money in your pocket as possible.
Today, let’s talk about 4 things you can do before you receive care to keep your costs as low as possible:
Choose an in-network provider
Get any necessary pre-authorizations
Take a current copy of your insurance card with you
Know your deductible before you go
1. Choose an In-Network Provider
If you have health insurance through your employer, did you know you have a “network” of providers you can use? That simply means your insurance company has negotiated a discount with certain doctors and hospitals who provide care. By choosing a provider who is in your network, you’ll benefit from those discounts and automatically save money.
If you have original Medicare, you can choose any doctor, but make sure you choose one who “accepts Medicare assignment” and not just participates in Medicare. If you have a Medicare Advantage plan, you still have a network and need to choose a provider in your network.
Tip: Even if your primary care doctor refers you to a specific specialist, double check to make sure the specialist is in network. Your doctor doesn’t always know who is in your network.
2. Get Any Necessary Pre-Approvals
Some plans require a referral, prior-authorization, or pre-certification before you see a doctor or receive treatment. If you don’t get the proper approvals in advance, you claim can be denied and you will be responsible for the full price. Don’t let this happen to you.
Review your plan’s requirements before you go, to make sure you use your benefits correctly.
Note: You probably don’t have to worry about this if you’re just seeing your regular doctor for a sinus infection. But, if you need to see a specialist, have physical therapy, or have a diagnostic like a CAT scan, you’re more likely to require an approval.
Tip: Most providers used to do this for you, but more often you have to do this yourself.
3. Take a Current Copy of Your Insurance Card
This one is such an easy one to do – when you have a health insurance plan, they’ll send you an insurance card. Make sure you take your card with you to your doctor. This is especially important on the first visit of your new insurance year. Sometimes your insurance company stays the same, but your ID number has changed.
For example: You may have had plan A last year, but switched to plan B this year. Your insurance has changed, so make sure you take the correct card.
If you don’t have the correct card, your insurance will deny your coverage because the numbers don’t match up.
Tip: Most insurance plans will allow you to print your card right off of their website.
4. Know Your Deductible Before You Go
People are telling us that their doctor’s office is asking them to pay their full deductible up front before they receive care.
For a doctor’s office, you’ll usually only pay your copay up front. If you have an outpatient procedure (X-ray, CAT scan, MRI, colonoscopy, etc.) or diagnostics, you may be asked to pay 100% of your deductible up front. If you don’t keep track of your deductible on your own, you could be paying all or part of your deductible twice. Although that may be refunded later, we don’t want you to pay out of pocket for expenses you don’t owe.
Tip: If your company provides HooPayz.com to their members, we have a tool to help you track your deductible. We hope these 4 simple tips will help you save money before you even go to the doctor. Spend your money on things you actually want to spend it on, like groceries, soccer camp, or that vacation you’ve had your eye on.