Approximately 67% of people who have insurance coverage have private insurance. If you choose provider services that aren’t covered by your private insurance, you’ll be required to pay a large portion of the bill out of pocket. You may need to go out of network from time to time out of personal choice or because the group health provider you see referred you to a specialist who isn’t in the network of coverage. Here’s how to deal with out of network care providers with your care network repricing insurance.
Contact Your Insurance Company
Before visiting any healthcare professionals you may believe are group health providers, it’s a wise idea to contact your insurance company before your visit. By planning ahead, you can avoid being surprised by unexpected medical bills. Find out if your plan covers any of the client services you’re expecting to get. Get any answers you receive in writing in case the care network repricing insurance chooses to change their policies after you’ve received approval.
When you contact your insurance company, avoid asking if the healthcare service or professional works with your insurance. While a healthcare facility may work with your care network repricing insurance, they may only pay for a small percentage and leave you covering the rest. Double-check any services you may receive for coverage, such as lab tests. If there is a service that you need that isn’t covered in your network, you may be able to request a network gap exception to cover the costs.
How To Handle An Out Of Network Bill
Dealing with out of network expenses can be frustrating because there are so many different pricing structures for the insurance company than for you as an individual. An MRI can cost the insurance company $1,300 but cost you $2,400 as a service out of network. There are a few things you can do to try to reduce the bill you receive. You can complain to your insurance company to see if you can get them to pay. You can also try to negotiate the bill with your provider or hospital to see if they will reduce the bill or put you on a payment plan.
When it comes to care network repricing insurance, it’s important to stay vigilant to avoid any unexpected out of network expenses. Make sure you understand your policy and ask about coverage before you receive any new services. You’ll not only protect your health but your pocketbook as well.