Parenting Pointers: Back-to-School Health Tasks

Summer is really going now, but school starts in just a month in some places which means children need to get their check-ups and vaccinations. ExHale Healthcare Advocates® is a healthcare company that saves individual consumers time, money and emotional stress by managing their healthcare relationships for them. ExHale Health uses industry experts who know how to work the system to help individuals get the most from their insurance plans. I had an interview with ExHale Health founder/CEO Sarah O’Leary can give parents’ tips on how to keep medical visit costs down, file paperwork correctly, and provide helpful suggestions about keeping up to date and accurate records regarding their children’s health.

1) What items should be on parents' back-to-school to-do list regarding kids' health?

It’s always good to book your child’s check-ups early. Pediatricians in particular get very busy during the back to school time period. Even if your school does not require an annual physical exam, it is a good idea to make sure your child is healthy and up to date on any/all immunizations. 

2) Healthcare can be expensive. How can parents save on healthcare costs and avoid overpaying on insurance?

Carefully review your insurance plan. Most people take less time choosing their plan than they do watching a movie. Make sure you’ve picked the best plan for you in terms of overall coverage including deductible, premiums, co-pays, prescription costs, etc. Plans are not all the same, and the time you spend to review your plan annually could save you thousands of dollars.

If you have a PPO insurance plan, make sure that your pediatrician is a preferred provider in your insurance company’s network. It’s also a good idea to make sure that the hospital your doctor has an affiliation with is also in your network. Out of network doctors in out of network clinics and hospitals are avoidable expenditures. If the doctor/hospital is really important to your family and out of network, you might want to consider changing to another insurer if that’s an option.

Don’t pay the bills your receive in the mail for visits, tests and procedures that should be covered by your insurance. Often healthcare providers will send you a bill to see if you will pay the amount they did not receive from the insurance company. Before you pay anything, review the bill, check with the insurance company and healthcare provider to see if an error as been made. Consumers pay an estimated $2 billion dollars every year that we do not owe.

3) What are some tips you can share for keeping medical paperwork organized?

Most healthcare providers have finally moved to standardized claim forms. This alone should help make the process a bit less confusing. 

Ask for a copy of every document you sign, and a copy of all medical tests/reports for your files. If you have blood tests performed, ask for a copy for your files. Keeping a long term history on every family member will help you when you switch healthcare providers. Although many forms are automated, it’s smart to print a hard copy and keep a file somewhere safe in your home.

Ask for itemized copies of all medical bills and Explanation of Benefits (EOBs) from your healthcare providers and insurers. Never simply accept a bill that is not itemized to include medical billing codes and a description of the procedure.

4) What can parents do if a claim is denied?

Parents should call the insurance company and file an appeal immediately. A new law requires that the insurance company answer within 72 hours of the appeal. If the insurance company remains uncooperative and the parents believe the claim is justified, they should contact ExHale Health immediately for a free consultation with one of our experts (info@exhalehealth.com or toll free 1 800 381 4741).

If a medically necessary test or procedure is denied, parents should also file an appeal immediately. If the insurance company does not waiver, it is important to get expert advisement. If necessary, we will even contact the state insurance board on our clients’ behalf to get fair resolution.

5) What are some common mistakes parents make and how can they avoid them?

#1: We pay bills we do not owe. Billing errors are commonplace in the healthcare industry, and far too many providers charge more than they should just to see if consumers will pay. Know your policy parameters, check to make sure your bills are correct, and never simply pay a bill because you receive it.

#2: We don’t negotiate for the price of procedures or services up front.  If you know your child needs a test or procedure that isn’t fully covered by insurance, shop around in your area to see where you can find the best price for it. 

#3: When we owe money to a medical provider, we do try to negotiate the amount before we pay it.  Even after a test or procedure or visit has already occurred, you can still save money by calling those involved and negotiating a better price, provided you know what you’re doing.

Healthcare management takes time, and you have to possess a working knowledge of how the system operates if you want to get all the healthcare you deserve at a fair price. If you’re not sure your healthcare, whether its about which policy to choose or bill resolution after a major life event, call ExHale Health for a free consultation.