Insurance at the end of the year….

As we approach the end of the year, there are a few things to keep in mind with regards to patient’s health insurance.
1) For many people, their deductibles may actually, finally, be met! This means they should use their benefits as much as possible while their responsibility is much less before the new year and when most people’s deductibles start over.
2) Double check where patients are in their benefits. Towards the end of the year, they may be close to maxing out their benefits. Knowing how many visits a patient has left under insurance can help avoid costly patient balances.

3) Some patient’s may have met their out of pocket. The patients annual financial responsibility may be met which means any patient portion suddenly become payable, in full, by the insurance. Make sure when you receive a patient’s EOB to check that you aren’t charging the patient when you shouldn’t be for co-pays or co-insurances.
4) ASH benefits will be dwindling. With this comes the fun requests for releasing visits from prior authorizations. For example, a patient who has come off and on all year recently returned. Upon doing the authorization, I checked her benefits and know that she had 4 visits left for the year. Although we requested 4, they only authorized 2 because they show her as maxed for the year, but she wasn’t. What happened was that ASH had authorized all of her benefits for the year. When you don’t use all of those visits that were authorized, you must go back to each authorization, find the unused visits and request that ASH “release” them thus making them available again.
Remember, at the beginning of the year, it becomes imperative to re-verify all patient’s insurances, get new ID cards, updates from your patient’s, etc. More to come on this as we approach the end of the year.

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