Walking the Maze of Health Insurance Claims

Saturday's NY Times article, Hands to Hold When Health Care Becomes a Maze (should be blog friendly), sums up most of our experiences with claiming health insurance benefits.

Caveat emptor is the rule.

I don't how this translates into Latin, but the phrase should be Buyer be Forewarned.

One source to arm yourself, according to the article, is the Agency for Healthcare Research and Quality, at www.ahrq.gov.

Another is the plain old way: read the materials and ask questions.

Make friends and allies like Medical Billing Advocates of America, an organization that trains advocates for consumers and companies to catch and fight errors in medical bills.(Now THIS is a growth industry. I wonder if they're publicly traded.)

I'm not sure how our health care industry became such an adversarial-based industry. Being the jaded, cynical person I am, it sure looks as if all the confusing jargon and sleigh-of-hand policies and obscure decision-making and no accountability benefits everyone but the consumer, the patient. Until that changes, there's unlikely to be significant change.

Side-bar: Here's a line from the article I liked:

If it turns out in the end that you do owe a huge amount, do not ignore it. Call the hospital or provider and tell the administrator what happened. You can ask if the rate can be reduced to what the insurance would be charged, which is lower than what a person without insurance has to pay.

Now why does the rate charged depend on a person's insurance coverage or its lack? The procedures and the care is the same. Why are uninsured penalized with higher prices for the same procedures?