When you have health insurance it can certainly make your health care experience much better. Most of the time our insurance company can handle all of your billing matters, which frees you up to simply focus on getting better. That is, after all, the most important thing. However, that does not seem to be the case for many who have insurance claims, which adds stress to a person’s recovery.

Another thing that is great about having insurance is that you don’t have to pay for all of your bills in one large chunk. The insurance company takes care of your bill most of the time. Generally, you pay your monthly premium and then whatever co-pays (if you have them) and the insurance company handles everything else. Sometimes not so true. Many patients have shared with me their Medical Insurance “nightmares”. These include denied claims for which the patient has to battle it out with the insurance providers for services that in fact are covered by their insurance policy.

However, the insurance company might only pay a certain amount or a certain percentage of the bill (or coverage over the year). Sometimes you opt for a service that isn’t covered by your insurer.

Whatever the reason, sometimes you have an outstanding balance in your account. The good news is that most of the time you don’t have to pay for all of this at once (after all, that is the purpose of having an insurance company). But if you still have this outstanding balance at the end of the fiscal year you might want to consider asking for end-of-the-year debt forgiveness.

Your insurance and medical bills are just like any other account. And like all financial accounts there is sometimes a chance that you negotiate your way to a lower payment or even total forgiveness of the debt.

While it is not always likely that you can have the account cleansed or even reduced, it really cannot hurt to ask. It might seem like your doctor and your insurance company don’t care about you but in reality you are important. And if forgiving your bill can make it easier to retain your business, it can sometimes be beneficial to the insurance company too.

But while most people are most aware of this payment system, it is totally possible to pay cash for your medical services. However, if you plan to do this you should know that you might be in a lot more complications.

For one, each doctor might charge a different charge for the same service. If you have insurance, your provider knows how much they are going pay up front for the service. This might be a percentage or a flat dollar amount. Once this cost is covered, the doctor may be required to forgive the rest of it. Of course, the charges are passed down to you as the client.

And insurance providers might also negotiate with the doctor to pay for certain costs as well. This is, perhaps, the most important thing you need to remember if you want to make cash payments for your health care.

Indeed, if you work a cash system you should have a strategy for negotiating your costs. Doctors are in business to provide a medical service to people who need them; a hospital is there to provide the best access to these medical services. Maybe you get all of your work done with a particular clinic or hospital. That means your services are all to the same company. Like most businesses, your loyalty may have a great reward in the form of discounts.

If seeing your doctor intimidates you, it might make you feel better to remember that you have rights as a patient. As a matter of fact, it might really benefit you to think about it this way: doctors need patients in order to successfully do their jobs.

And because of that, you have certain rights that not only ensure you get the care you need, but also ensure that you feel your doctor(s) care about you as a person and not just a client.

One of the most important rights you have as a patient is the right to privacy. This protects your personal information but also protects your feelings. Your health is a private matter and sometimes the conditions you end up having are embarrassing or sensitive. While there is certainly no shame in contracting or developing any illness, some things can be difficult to talk about.

At the same time, this is also a time when personal information is precious to thieves and so you want to be sure that any information you give to your doctor is safe from that threat as well.

This is becoming more true, too, because many hospitals are moving towards electronic records. As such you, you want to be sure that your e-records are accurate and up to date. In the same way that it is important your credit is updated, you should make sure that your medical e-record is also up-to-date.

But the reason for updating your records is not just to make sure that you are safe from harm; it is also important for your records to be updated when you see a different doctor or a specialist who might request your medical records. They need to know which procedures you have had, what allergies you might have, and which medications you are already taking.

Seeing the doctor to deal with health issues can be difficult enough, but many people find the real headache comes from trying to deal with insurance companies. Yes, this can be a stressful experience, but if you are prepared you will find it is much easier.

First Steps When Faced With An Insurance Issue

Remember that nobody is perfect. Issues arise out of confusion not out of conflict. Sometimes there is miscommunication and sometime it is just misinterpretation of information. The latter is actually pretty common when dealing with insurance companies because the lingo and the structures of their schedules can be complex. This is even more common today because of the constant changes in regulation. Often the insurance company will deny claims initially in hopes that the patient will give up on pursing the insurance claim. As a provider, this has happened to me personally. I recommend and empower people to follow-up and question the decisions made by the insurance company. After all you are paying for the services that the insurance company is providing for you!

So the first thing you might want to do is make sure that you understand the source of the problem. Is it that you don’t understand some fine print in the policy? Is it that you can’t find someone to answer your questions? Are you having trouble with the benefits schedule?

Cut to the Chase: Navigating the Chain of Command

This is actually an important strategy you will want to plan ahead of time. Navigating the chain of command is not always easy; just be sure that you are courteous and exact. Know what you are looking for and how to ask for it so that you can get directed to the right person. Keep all information that they will ask (policy number, personal identification information, etc) on hand because they will probably ask it every time you get transferred.

Best Practices In Documenting and Communicating

And while you have that information nearby, make sure you keep a pen and paper with you as you document who you talk to as you navigate the chain of command. This is how you keep the insurance company accountable for the information they provide and how well they perform their customer service. Ask precise questions and keep track of the answers. And if you are not receiving the information or there is confusion, do ask to speak to a supervisor.