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Your health care.
It's an issue contend with on a daily basis as costs rise and we pay more out of pocket expenses understanding the health care system.
Is more important than -- here at the -- report we're devoting entire week to getting the tips tools and strategies of an industry that is often steeped in shadow and red tape tonight.
Private health insurance companies raising prices breaking -- profits between 2010 and 2013 premiums have grown a staggering 14%.
Consumers can feel conflicted by haven't had billion dollar for profit industry.
Manage their health care and for good reason our next gets rebuilt the policies that are designed to take even more money out of your pocket.
Here -- -- doctor Pamela Galen author -- how to survive her doctor's care and these are great books by the way I've read them are fantastic one.
Let's start though with talking about people feel intimidated by insurers.
What -- the games they play their many games the goal here is not to reimburse the provider.
And in turn the patient so the first one is we've lost your paperwork we didn't fill it out correctly.
Another one is you're not covered anyway and therefore we will not reimburse you.
And the other is your doctor get it wrong so they -- she real hurdles so that on each turn off fewer people will get to the next point which is your reimbursement.
And we should establish -- -- practicing physician so you know what you speak up because your right in the middle of all of this and not patient wife and mother for so yes I'm on both sides here on both sides.
So we talked before you talked about this practice of coding up.
What is that and what does it mean for consumers OK everything is.
Based on the code which is a transaction they think of -- -- -- skewed number four.
What your doctor gave you.
And it's very specific the insurance basically don't want to pay.
And the providers which of the hospitals and physicians do want to pay and the patients would like to be reimbursed or have their services covered.
However it's fraud to save it you gave a service -- did not provide that said.
There's very much a -- zone and there -- degrees for people.
In how to code if you have to -- -- if you two legal proceeding to -- procedure that has to explanations.
One might be reimbursed at a higher level in the other so you're told you're -- -- when I go to professional meetings there are now classes in how to code to your advantage.
Code to the inch.
Code to be to the providers advantage -- we are given classes.
Always legitimate -- say please use this code because you'll be reimbursed at a higher level.
But behind the scenes in large institutions are people who are expert in figuring out.
What to do.
And I think what you're saying here maybe between the lines a little bit is that insurers.
Are trying to get.
The lowest price tag access to whatever service or test or procedure the patient -- -- right yes -- Well that's disturbing and that's -- first time I've ever heard about coding up.
The other thing you say that I think is really interesting is the deductible.
Well it's not the deductible.
I'm on an account.
And that you need to -- an accountant and you need to read the fine print in your policy because what happens is.
Very specifically you might go for a 250 dollar examination and think -- torn from Dallas is being applied to your.
Deductible in fact.
It's usually depending on your plan Medicare plus 10% -- two and fifty dollar.
He might really be eighty plus ten.
So in fact you might not -- doctor -- plus the deductibles are allocated into three buckets one -- here.
Medications one there is -- how are your hospital based treatments and -- your providers treatments under three different.
Areas so it's at very complex and extremely confused.
-- -- So it sounds like it's very hard to breach that deductible and -- you have some experience yourself with this yes if you are in a no deductible plan and you only go to doctors that.
Are within your insurance you're really OK except for the small co -- If for example for a shop for a self insured my son -- surgery at the end of the year and I thought well there was it was Cleo and I would reach into the deductibles in fact I did not.
Much to my surprise and that's when I found this out I did not know that -- so even have -- Okay well so -- -- why do we who were my allies as a consumer.
Okay my turn to it there are few if -- women and large institution.
Find a person in HR because they will run interference for you with a health insurance and please cover this person.
If you're an individual it's a little bit more challenging there are companies and individuals are rising -- represents -- And in each state the attorney general can be your friend.
Factor panel and going great stuff great information thanks for coming on the show we hope to see you again soon thank you --
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