Insurance 101: Educate yourself!
Many of you will be shopping around for new insurance in the coming months, and I wanted to offer a few tips. When speaking with the companies, be sure to ask the right questions, especially if you are looking for good reimbursement coverage of your ECN appointments. Dr. Molly Niedermeyer, Dr. Kelley Barnes-Valdes and Dr. Erin Westaway are always considered out-of-network, as they are not contracted with any insurance companies. Please be sure to ask 1) What is myout-of network deductible (this is completely separate from your in-network deductible)? 2) At what percent is out of network reimbursed?, 3) What are my co-pay and co-insurance? The answers to these questions will greatly vary not only between different companies, but different plans as well, so be sure to do your homework!
If you’d like someone to do this homework FOR you, we recommend Sarah Freeman at Mutual Benefits: 206-709-2619. During a free meeting, Sarah will speak with you about what kind of coverage will work for you and your family, and then present you with multiple plan options that will suit your needs. If you work with Sarah, be sure that you still know the answers to the questions provided once you are established with a company so there are no future surprises.
Once you have established a company that you are comfortable with, be sure to pay attention to the explanation of benefits that you receive in the mail or online. Often times, the insurance company will deny claims for reasons that can be remedied, and you will receive reimbursement once corrected. Look for words like documentation, bundling, and yearly service already covered. Let your ECN doctor know, and we can correct the superbill that was given to you for reimbursement.
Remember that our clinic manager, Amanda Zuluaga, is always available to help you with your insurance needs!