Stop asking your provider if they take your insurance?

Do you take my insurance? 

Yes, most providers are likely to “take” your insurance.  They will charge you the copay or deductible on your card and as a courtesy, bill your insurer for their share.  But, let’s be clear.  The reason you are asking if they “take” your insurance is not to learn if they will submit the claim on your behalf.  You are asking because you want the best value for your benefit dollar.  Are they an in-network provider?

If they are a participating provider, you are responsible for your copayment or deductible, and your insurer will pay the remainder of the negotiated rate.  If they are not, the insurer will often provide some coverage (unless you have an HMO) and you will be left with the balance of the bill. The difference is the amount you are responsible for. And, this amount can be hair raising. So what can you do?

Rather, ask if they are an “in-network” provider. The more specific you get the better. For example,”are you an Aetna Open Access Managed Choice PPO provider?”  I know this may seem extreme. But today, health insurers maintain multiple networks under their umbrella and providers and facilities are not contracted with each.  If the receptionist is unable to confirm participation in your specific network, you should contact your plan’s member service team or log on to their website for a provider directory search.

Stop asking your provider if they take your insurance.  In this age of consumerism, you are ultimately responsible for obtaining your provider’s network status. Retrain yourself on how to approach your next visit and take advantage of the significant savings.

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