Business Insight presented by Arlington Dermatology New Year, New Insurance Your insurance card seems to look the same. You do not know of changes from your employer. Yet, some services get denied. Your pharmacy charges you several hundred dollars. Your doctors sent you a bill. Sounds familiar? Every year, our patients go through the same set of questions asked by our office front desk personnel. We do it not to annoy you. We do it to prevent unpredictable charges and costs. Even though you may not seem to know of any changes, sometimes it is a letter added to a group number or a pharmacy contract changed by the insurance itself. Changes are hidden in the way the plans are formatted and even we cannot see that by looking at the card. However, once we utilize the feedback of benefits verification, it all shows upand allows us to process claims or direct prescriptions to the correct pharmacy. Our ever-changing healthcare system introduces hundreds of new plans every year. Some plans are designed in a very standard way, with some deductible and co-pays. There are many new types of plans that use saving accounts and cafeteria plans, and they do not work exactly like other commercial carriers. Some employers decided to become self- insured due to growing costs of premiums. Some others offer lower premium costs but very high deductible, making using the benefits almost a catastrophic move. Not many people can come up with $10,000 or more to pay out of pocket before the insurance kicks in. co-pay might have gone up, prescriptions may have several options depending on whether you use brand drug or generics. Each insurance plan should have a benefit phone number listed on a card. While you may not be able to speak with a human being, benefits are often pre-recorded as a long message and may give you at least some information before you see your doctor. Some patients say, oh I never really use my insurance' and they do not get interested in the specifics. And this is why they often get surprise bills. We never know when and how we might need to use medical insurance. And yes, we prefer not to have such a need. But often, it happens as a surprise, accident, sudden sickness. During Covid-19, many of us got that surprise. We should always be prepared to use our insurance to our advantage. Medicare plans change as well. Commercial insurance businesses introduce many new plans, tempting seniors with 'extra' coverage and payments for transportation to the doctor. Or offering a health club membership. Please, always read the small print. You may gain a bus ride to your doctor but your doctor may not accept your medicare insurance anymore. Only because it is no longer real medicare but rather a substitute for medicare, underwritten by a private commercial carrier, like Humana. Often, these plans limit the network of medical providers and pay only for those doctors who are in network. So when my office staff asks you for a verification of your demographic information and insurance, they do it to help you and prevent any unpleasant surprises after the visit. Make sure to have it handy. We always like to see you on time and respect your scheduled hour. You can also use our website and print the forms in advance of your upcoming visit. Before you agree to use any medical services, you should revisit some summary of your benefits. Even if your medical insurance system work for us and not against us. did not change the plan, it may have limited some of the services that are covered. Your Working together, we all help our healthcare Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net Business Insight presented by Arlington Dermatology New Year, New Insurance Your insurance card seems to look the same. You do not know of changes from your employer. Yet, some services get denied. Your pharmacy charges you several hundred dollars. Your doctors sent you a bill. Sounds familiar? Every year, our patients go through the same set of questions asked by our office front desk personnel. We do it not to annoy you. We do it to prevent unpredictable charges and costs. Even though you may not seem to know of any changes, sometimes it is a letter added to a group number or a pharmacy contract changed by the insurance itself. Changes are hidden in the way the plans are formatted and even we cannot see that by looking at the card. However, once we utilize the feedback of benefits verification, it all shows upand allows us to process claims or direct prescriptions to the correct pharmacy. Our ever-changing healthcare system introduces hundreds of new plans every year. Some plans are designed in a very standard way, with some deductible and co-pays. There are many new types of plans that use saving accounts and cafeteria plans, and they do not work exactly like other commercial carriers. Some employers decided to become self- insured due to growing costs of premiums. Some others offer lower premium costs but very high deductible, making using the benefits almost a catastrophic move. Not many people can come up with $10,000 or more to pay out of pocket before the insurance kicks in. co-pay might have gone up, prescriptions may have several options depending on whether you use brand drug or generics. Each insurance plan should have a benefit phone number listed on a card. While you may not be able to speak with a human being, benefits are often pre-recorded as a long message and may give you at least some information before you see your doctor. Some patients say, oh I never really use my insurance' and they do not get interested in the specifics. And this is why they often get surprise bills. We never know when and how we might need to use medical insurance. And yes, we prefer not to have such a need. But often, it happens as a surprise, accident, sudden sickness. During Covid-19, many of us got that surprise. We should always be prepared to use our insurance to our advantage. Medicare plans change as well. Commercial insurance businesses introduce many new plans, tempting seniors with 'extra' coverage and payments for transportation to the doctor. Or offering a health club membership. Please, always read the small print. You may gain a bus ride to your doctor but your doctor may not accept your medicare insurance anymore. Only because it is no longer real medicare but rather a substitute for medicare, underwritten by a private commercial carrier, like Humana. Often, these plans limit the network of medical providers and pay only for those doctors who are in network. So when my office staff asks you for a verification of your demographic information and insurance, they do it to help you and prevent any unpleasant surprises after the visit. Make sure to have it handy. We always like to see you on time and respect your scheduled hour. You can also use our website and print the forms in advance of your upcoming visit. Before you agree to use any medical services, you should revisit some summary of your benefits. Even if your medical insurance system work for us and not against us. did not change the plan, it may have limited some of the services that are covered. Your Working together, we all help our healthcare Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net