How High Healthcare Insurance Costs Can Be Reduced

Health insurance companies contribute to the high cost of healthcare through internal inefficiencies. Consider this actual scenario with a large healthcare insurance company. For many PPO type healthcare insurance policies one is faced with determining whether the healthcare provider they want to visit is in-network or out-of-network. They get the maximum reimbursement using an in-network provider.

To enable the customer to check on their providers network status the insurer's web page has a link to a Find a Provider search. Typically the in-network providers within the geographical area you specified are listed. If you see your preferred healthcare providers name or facility you feel relieved. As you get ready to close the page you notice a disclaimer that says that the insurance company is not responsible for determining that the provider is still in-network. They say the customer is responsible for contacting the healthcare provider to determine that the provider is indeed an in-network participant.

Clarification Call to the Healthcare Insurance Company

In this scenario the physician was listed but not his one of two offices closest to our house. I called the healthcare insurance company to clarify this since I didn't want to drive across town to his office at the hospital. After a 14-minute wait followed by numerous options to enter every digit possible I finally was able to speak to a person. After explaining this quandary they indicated that even for facility coverage questions I really would have to contact the provider to determine if they were in-network at either location. The representative spent about 4 minutes on this call.

Call the Heathcare Provider's Office