- If you are making an appointment with a new doctor, hospital, or lab, always make sure they accept not only your health insurance company’s insurance, but that they accept your plan (HMO or PPO).
- Make sure your doctor has received approval for any procedure or surgery ahead of time (unless you are in an emergency situation).
- When you do receive an approval for a procedure or surgery, ask the medical personnel to make sure the medical procedure code approved from the insurance company matches the medical procedure code requested by your doctor.
Example: Your doctor may request an abdominal scan using dye but the insurance company only approves an abdominal scan without dye. If they conduct the exam with dye, you may be responsible for the difference in price for the procedures.
- Your doctor can appeal the denial and it may be approved with an expanded explanation to the insurance company. If your doctor’s request is not approved, you may end up paying 100% of the service provided.
- Pharmacies charge different prices for the same prescription. Shop around to find the most competitive price. Also, each insurance company offers mail-order prescription service for drugs that you take on a continuing basis for a lower price than you can obtain directly from your local pharmacy.
