Squeezing Your Health Care Dollar

April 9th, 2009 – All across Colorado, people are having to find ways to try and do more with less. Certainly with the ever increasing costs of health care services you have to be careful to avoid the pitfalls and get the most for your hard earned dollars.

Here are a few tips to help you get more health services with less of your money:

1. If you have insurance make sure you are within the PPO or HMO network for non-emergency situations when possible.  If you have plan with a deductible staying in-network may reduce your out of pocket costs by 45%.
2. Don’t assume that just because your doctor or hospital is in-network that the lab they use is too.  Verifying the lab is in-network can make the difference between a bill for $500 and one for $50.  That’s right, the discounts for lab work can be as high as 90%.   Go out of network for lab work and it can cost you – big time!
3. Wait until you get your Explanation of Benefits (EOB) from the health insurance carrier before paying bills and carefully compare the EOB with the provider bills.  If you think something should have been covered on the EOB and it wasn’t don’t get angry.  Investigate!  9 times out of 10 the reason it wasn’t covered has to do with the way the provider coded the claim.  With some effort this can be corrected.
4. If you don’t have insurance be careful!  Many hospitals charge significantly more to people without insurance, so be assertive and ask about cash payer discounts or work to negotiate a payment plan if they agree to a reduced payment amount with the hospital. Do some research to find out how much they would have been paid if you had insurance.
5. For non-emergency treatment don’t be afraid to ask what things will cost up front.  Increasingly, providers are happy to give you this information, although there are still providers that still refuse to.  Make sure you are getting quality service from a well qualified provider with a good track record for the treatment you need and at a fair price.  Costs for a given procedure care vary significantly from one hospital to the next, even in the same town.
6. Carefully shop for health insurance coverage.  Beware of buying insurance online without fully understanding what is covered when.   Generally it is best to use a local broker that understands which of Colorado’s carriers are best suited for your partcular situation.  This not only can help save you money, but it can also save you a huge of time and effort.

Remember, the squeaky wheel gets the oil.  Dealing with the beauraracy of hospitals, doctors offices and insurance companies isn’t fun, but the extra effort you put in to be sure you are being treated fairly can save you money.