February is National Wise Healthcare Consumer Month. Prowers Medical Center wants to share the following tips and guidelines to help you become a good consumer of healthcare.
Be Selective when Shopping for a Healthcare Plan, your Provider and Services
Stay in the know about your specific healthcare plan benefits so you’re well prepared in advance for routine check-ups, or when an emergency arises. Healthcare plans and benefits can feel overwhelming, leaving many in the dark about what their coverage is. “Researching is good, but more importantly it is good to know what your insurance will cover and what it will not,” said Hernandez.
Know if your benefits cover outpatient hospital services, as well as inpatient services. Learn what your out of pocket expense is. Know how much your deductible, co-insurance and copay amounts are. Make sure you understand what specialty services your plan will cover, i.e. surgery, physical therapy, etc.
Before scheduling your next routine check-up, be sure to know whether your healthcare plan requires you to have a primary care provider. If they do, learn if your provider is in network or out of network for your healthcare plan. The financial difference on what the insurance company pays will depend on whether they are in or out of your healthcare plan’s network. Know if your healthcare plan covers specialty providers, such as a cardiologist, an oncologist, or an orthopedic surgeon.
Preventive Care, Schedule Your Routine Check-Ups
The Centers for Disease Control and Prevention defines preventive care as: “Preventive care includes health services like screenings, check-ups, and patient counseling that are used to prevent illnesses, disease, and other health problems, or to detect illness at an early stage when treatment is likely to work best.” Preventive care can help you stay healthy—keep your health in mind.
In addition to your preventive care, remember to maintain a healthy lifestyle: include vegetables and fruits in your eating plan, get your daily exercise and keep your weight in check.
What to Expect When You Come to the Hospital and Register for Services
Going to a hospital for surgery or other treatment can be difficult for patients, especially if you haven’t been admitted to a hospital before. When you arrive, you will need to register to make sure that all of your personal details are correct. You will be asked to verify your name, address, phone number, primary care or ordering provider, and insurance carrier. It is important that you bring your insurance card and a current and proper form of ID with you. You will also need to know what services you are having done so we can confirm that this information is properly entered into the system. Know your co-pay amount and be prepared to pay that amount during the registration process.
The Prowers Medical Center Patient Financial Services department has an open door policy to help patients review their bill and subsequent explanation of benefits (EOB) related to that bill. “Our team has assisted a patient that would come in every quarter when she received her Medicare Summary and would bring all of her insurance documents for her and her husband,” Hernandez said. “We would match everything up and make sure that services were being paid appropriately,” she explained.
If you have questions or need help understanding your patient bill, please contact the Patient Financial Services department at Prowers Medical Center by calling 719-336-5571. We are here to help.