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Copyright© 2002 to 2005
Marlene R. Fedin
is who you think you should be. Relaxation is who you are."
January 13, 2005
Committed to Health
Part One: How to
Manage Your Healthcare
By Marlene R. Fedin, The Wellness Concierge®
Copyright© 2004, Marlene R.
Fedin; no reprint or reuse, on or offline,
express permission of the
Responsibility for Your Health and Well-Being
Educated and Pro-Active Healthcare Consumer
Get the Best Health
Insurance You Can Afford
Health Insurance Plan
Medical Evacuation Insurance
Hire a Healthcare
Do the Grunt Work—or
Work With Your Physician and Other
Medical Services Providers to Get Maximum Coverage
Check Fees—Before You Commit to Treatment
Negotiate Fees in Advance
to staying healthy on and off the road than good dietary and exercise
habits. But even individuals with healthy habits often fail to
address the basics of personal healthcare management. In today’s
error-ridden and fiscally challenged healthcare landscape, that can
lead to physical and financial disaster.
personal healthcare management is particularly challenging for road
warriors who literally don’t have the time or resources at hand for
a lot of the research and maintenance work that is the cornerstone of a
functional personal healthcare plan. Fortunately, there are resources
and services to help with the process.
starts with the #1 rule:
Assume Responsibility for Your Health and
deserves quality healthcare. Getting it is another matter. In the
maze of what passes for the healthcare system today, you have to work
and plan to realize the desired outcome. Bottom line: You need a
healthcare plan that you create and manage as diligently and carefully
as your personal financial portfolio.
Learn How the "System" Works—Then
Learn How to Work the System!
To hone your skills to successfully navigate
your way through the healthcare insurance and medical services
Become an Educated and Pro-Active Healthcare
healthcare is in your hands. You need to educate yourself about
the process of choosing physicians and hospitals; understanding
recommended treatments, tests, and procedures; how to work with
healthcare professionals and insurance providers to get necessary care;
how to get the maximum benefits from your insurance provider; how to get
and review medical records and bills; and how to research medications,
possible treatments, and other aspects of personal healthcare.
The Goal: Get
help, as needed, to research and understand your healthcare
coverage and medical options. Become an informed, responsible,
cautious healthcare consumer who routinely but respectfully
questions and reviews diagnosis and recommended treatment
options with healthcare professionals before committing
Get the Best Health Insurance You Can Afford
solid insurance, even a minor illness or accident can put a major dent
in your finances—and possibly plunge you into serious, long-term debt
that can negatively affect your credit. (Need a reality check on costs?
Without insurance, the tab for a two-day hospital stay, excluding any
surgeon’s or other medical professional’s fees, can equal the charges
for two to three weeks
at a top spa!)
insurance must be a fiscal and personal priority even if you’re fiscally
challenged, young, or currently healthy. You may need to make some deep,
even painful, cuts in discretionary spending to fund your healthcare
premiums. (And yes, I realize that not everyone who works has
discretionary income to reallocate.)
If you aren’t offered any health insurance at work and you
can’t cover the monthly premiums for health insurance from your current
salary/income, you have to earn more—or find an employer who offers
adequate coverage! It’s a painful truth. But going without insurance
is not an acceptable option.
You may need to make some hard financial choices
(increasing your deductible, for example, or your out-of-pocket
contributions or even buying more coverage) to get the care you and your
family may require.
self-employed and/or an independent contractor, you must explore your
options and allocate dollars for purchasing insurance as if it was a
mandatory business expense—because it is. You are the
business. If you go down, so does your business.
shouldn’t take—or stay—in a job simply because of the healthcare
benefits. The daily stress and strain of doing work you dislike (or
which, in itself, is physically or emotionally dangerous) can negatively
affect your health in the short- and long term. Such ongoing stress can
weaken your immune system and make you more vulnerable to disease as
well as poor health habits (overeating and drug, alcohol, and tobacco
TIP: As more
people are forced to pay for their own health insurance, more and more
scams are surfacing. Even seemingly legit providers have left
policyholders in the lurch in recent years. Never commit your financial
resources without carefully vetting an insurance provider. And if a
premium sounds too good to be true, it usually is.
If you have
no back-up financial resources or are the sole support of your family,
you should consider getting disability insurance. Good coverage
isn't cheap but it can greatly contribute to the quality of your life if
you are unable to work.
Ensure your physical well-being without risking your financial
security or sanity. Secure—or purchase—affordable and
appropriate coverage. Allocate income to purchase primary or
supplemental insurance if necessary.
Review Your Health Insurance Plan
news: You have insurance. The bad news: Your plan seems to be written in
another language. There are few things less intriguing and more
challenging than reviewing your health insurance coverage. That may be
why so many otherwise financially prudent and intelligent folks neglect
to do so. But failing to fully understand what’s included in your
coverage—and, more importantly, what you must do to ensure that you
receive those benefits—can cost you both financially and physically.
to work your employer-sponsored or self-purchased plan to get the most
out of what’s available and to ensure that you are not denied coverage.
specifics of plan coverage are always subject to change. Contracts are
renegotiated, often with a reduction in benefits and an increase in
rules and required paperwork and approvals. You must have a solid
and accurate understanding of your current coverage.
Be sure you
understand exactly what benefits are provided and when they kick in—or
end. (Your physician may deem extended physical therapy a necessity but
your carrier may cut it off after a certain number of visits. Never
assume that a physician’s directives will ensure coverage.)
unclear about specifics or have questions, speak to your company’s HR
department or to the insurance provider. In some cases, it’s worth
investing in the services of a healthcare financial advisor (see below).
Ensure that you are covered for away-from-home emergencies;
that you are not disqualified or denied benefits because of
errors or omissions on your part; that you can fully utilize
available services and get the maximum coverage to which you
Confirm Your Travel-Related Coverage
questions for globe-trotting travelers:
Are you covered for out-of-city,
out-of-region, out-of-state, and out-of-country emergency and/or
non-emergency medical care?
If you are:
• What type of coverage is
• Is medical evacuation
• What approvals or other
requirements must be met before treatment can be ordered and covered?
• How is emergency care
defined? (What you consider an emergency, even what a local physician
may consider an emergency, may not meet your insurance provider’s
Purchase Medical Evacuation Insurance
is not provided by your employer, purchase a policy. It’s essential for
international travelers, but it is also an important consideration for
If you can't
get home, or elsewhere you specify, for proper medical treatment, you
could compromise your health. And with the high cost of medical
transport (we're talking five-digit fees in some cases), a policy may be the single best health investment you can
make as a road warrior.
TIP: Be sure you
understand exactly what is—or isn’t—covered by an individual provider’s
policy. You want to be able to specify your destination, for example.
Assistance (Check out the
Plus Program features:
secure online storage and maintenance of personal medical information;
real-time trip intelligence; free international cell phone use for first
week of travel; and up to $50,000 cash advance for medical
Hire a Healthcare Financial Services
You and your
family could have terrific health insurance and still find yourself
struggling to understand your plan and navigate your policy to get the
coverage and care you expect and need. Enter a new breed of financial
advisors, led by professionals such as
the founder of
Healthcare Financial Services
A seasoned financial exec in the
healthcare industry, Lan knows the ins and outs of today's complex
healthcare system. More importantly, he and other trained professionals, can
save you time, money, and your sanity.
are especially helpful for today's blended and extended families where
you may be juggling multiple insurers and/or complicated coverage.
TIP: Don't wait to
consult a healthcare advisor until you're desperate. Make him or her a
part of your regular financial advisory team.
Do the Grunt Work—or Delegate It!
Unfortunately, if you want to get reimbursed for healthcare expenditures
or ensure that your bills are paid, you often have to fill out a
seemingly endless stream of paperwork. (Think it’s tough for you?
Imagine what a physician’s office has to process for hundreds of
patients and the multiple insurance providers they rely on, all of whom seem to have
different forms and requirements—and numerous ways to deny or delay
payment. There’s a reason a growing number of physicians are refusing to
of required forms. Carry a few with you in case you need them on the
read the forms. Fill them out—completely and accurately. If you’re
unsure of what’s being asked or your answers, get help from HR or your
provider or physician.
if your provider and/or physician offers online forms or electronic
submissions to expedite processing.
blank or incomplete paperwork on your physician’s staff. Respect their
time and workloads. They have enough paperwork on their end.
to cut corners by omitting steps or information.
If you don’t
have the time to fill out and submit forms and track them, consider
hiring a financial advocate or other professional. (And unless your
secretary or assistant’s job description legitimately includes this
arduous and time-consuming activity, don’t ask him or her to do it.
Unlike your trip expense reports, it’s a personal, not a professional
Work With Your Physician and Other Medical Services
ever been denied reimbursement or payment for a legitimate medical
service only to have it approved when you re-applied, you know that
getting coverage depends on a lot of details and paperwork. Inaccurate
or incomplete information on your, or your physician’s end, can land you
in "Denial" land. So check your paperwork and be sure you and your
physician and his staff are in sync.
Even if your
insurance covers all of your bills, you should carefully and routinely
review physician and hospital bills. It’s been estimated that 90% to 95%
of all hospital bills have errors—incorrect billing codes, charges for
procedures and services that were never rendered, or errors in the
quantities and types of medications and services actually provided.
Do your part to ensure that costly medical billing errors
are corrected. Insurer payments for undelivered or mis-billed
services will only add to the cost of already high premiums.
As costs escalate, more and more employers are cutting back or
eliminating healthcare—and that affects all of us.
Check Fees—Before You Commit to
One of the
most painful aspects of medical care often comes after you’ve
received treatment. Even well-insured patients are shell-shocked when
they find out that an insurer will not pay the full amount of the
billed fees for medical procedures and consultations and services
from specialists and surgeons.
surgeon charges $15,000 for hand surgery, for example, but your provider determines
that it’s only "worth" $5,000, that’s $10,000 you have to pay!
(I’m using an example from a friend, a financial exec, who found the
bill hard to swallow even though she had a very healthy income at the
time and was insured by a top provider.)
is one of the few areas where people routinely do not ask about—and
physicians’ fail to offer details on—fees and other costs in advance of
booking and receiving the services. But you can’t bemoan the high cost
of healthcare without questioning what it actually costs.
are comfortable in this dialogue and many physicians and their staffs do
not routinely volunteer such information. (Although, if you have no
insurance, you’ll be having this conversation immediately after this
fact is ascertained!)
TIP: Don’t "shop" for
any medical care based on fees alone. The highest price doesn’t
necessarily insure the best care nor does a lower fee reflect a
physician’s professional abilities and experience. (Geography,
cost-of-business, and other non-skill-related factors influence fees,
which can account for the wide spread in some cases.)
FYI: Many of the best
physicians no longer accept any form of medical insurance. However, some
of them offer the best value in terms of actual fees. The surgeon’s fee,
including weekly visits for six months for post-op care, for a friend
who had minor surgery a few years ago was about 12% of the entire cost
of all her medical care and prescriptions. And this was a top NYC
surgeon. On the opposite end of the value scale, the anesthesiologist,
who provided a bit over 30 minutes total care, billed her for an amount
equal to one-half of what the surgeon charged! (Yes, she questioned the
Find out what you’re
actually being charged and determine what you can and will pay
for needed services and procedures.
Negotiate Fees In Advance (Applies
to the Insured as well as the Uninsured!)
your physician’s office manager and explain your financial and other
mitigating circumstances. In some cases, they may offer reduced fees
outright or in exchange for an up-front cash payment (rather than a
lengthy wait for provider reimbursement) or offer special payment plans.
In certain situations, where someone is temporarily unemployed and
uninsured, a physician may even waive a fee but that is generally the
exception and only for those in dire need of medical services.
(Note: I am
most emphatically not advocating that anyone routinely attempt to hondle
physicians just for the sport of it. Some folks simply do not know—or
accept—what is a legitimate, going rate for services. Some people always
want a discount on "retail" prices, even if they’re getting a bargain to
begin with. And although everyone is entitled to the best prices they
can negotiate, there is something unseemly, to my mind, about folks who
have the money—versus those who genuinely don’t—not wanting to pay the
going rate. When so many people literally can’t afford any healthcare, I
personally question the nickel-and-diming approach of folks who have
huge discretionary income not to mention substantial personal wealth. If
you can afford expensive vacations, luxury cars, and the like, you
should respect another professional's right to charge what is necessary
to stay in business. We need all the good physicians we can get and the
best are being driven out of medicine these days. And many physicians
are having a hard time making a decent wage given the demand on
their time and resources and the cost of doing business today.)
how their practice is set up, some physicians may not have the option to
lower rates (although I’d personally question any organization where an
individual who provides the actual service cannot negotiate his fees).
Some physicians simply refuse to do so, no matter the circumstances.
nothing to lose by asking and you should not be embarrassed to do so.
Some of the wealthiest people I know are the first to ask for a
reduction in the "sticker price" on everything—including medical care.
But do so respectfully and politely and as you would like to be treated
if you were providing the services.
approach to fee reduction applies to the costs of hospitalization and
Overcome your reluctance to confront actual healthcare costs.
Learn how to negotiate better rates from physicians and other
healthcare providers. Look for ways to legitimately cut
Part 2: The
Personal Dos of Managing Your Healthcare
Copyright© 2002 to 2004, Marlene
R. Fedin; no reprint or reuse, on or offline,
express permission of the author
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Marlene R. Fedin.
greatest problem in communication is the
illusion that it has been accomplished."
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