New Insurance and the Importance of Telling Your Provider
When you switch insurance providers or even just switch plan types with the same provider, it is important to let any healthcare facilities (and pharmacies!) you go to know about the change. This is particularly true with any facility where you have ongoing, regular appointments. If you do not tell your doctor’s office about the change, then there could be several consequences as a result.
When you switch insurance plans your patient responsibility may change. Maybe before you had $35 copay for a specialist visit, but now those visits require payments toward your deductible. This could be a lot more out of your pocket than you weren’t expecting. Letting your doctor’s office know your insurance is changing will allow them to help you figure out if this could be the case BEFORE those expenses hit your wallet.
Switching insurance means your new plan may have different requirements before you can receive certain types of treatment. Did you need a referral before? Maybe now you don’t! Or perhaps pre-certification was not a requirement for your last plan, but it is with your new one. If you have not told your doctor that you switched insurance, they will likely only find out when your claims begin coming back denied. If your insurance required pre-certification for treatment, then you could be paying the full out-of-pocket amount if one was not obtained ahead of the service. You could have had several visits without authorization before your doctor’s office finds out. And by then the cost could be significant.
A new insurance plan may not cover certain medical treatments at all depending on their policies. Although the best way to find out is to call your insurance directly, your doctor’s office would be willing to help you with this as well. But they can’t do that if they don’t know you’ve switched plans. Imagine having had several visits with your doctor only to find out all your claims were denied because the treatment was not covered. You, the patient, could be completely financially responsible for any services performed.
Unfortunately, most medical facilities will not receive any kind of alert when their patients have changed insurance plans. It is completely up to the patient to provide the office with any new information. The Billing Team at Wilson Pediatric is more than willing to help you figure out potential costs when you switch insurance. Just let us know as soon as you do so we can help you avoid any unexpected expenses. And although we will do our best to let you know what you can expect, your insurance company is still the best source of information when it comes to your benefits. So if you are changing insurance any time soon, just shoot us a text to let us know! You can even just send a picture of your new insurance card and we will update your kiddo’s profile on the spot. This way we can let you know of any changes to your costs BEFORE their next visit.
