Insurance Woes?

April 27, 2018


You have health insurance, right?  So WHY are you getting a bill!!!!


There are several things that are important for you to know about your insurance.  The first is:  does your healthcare provider "participate" your insurance.  In most cases providers have to enter a contract with an insurance company to be considered as participating.  This means that we send the bill to your insurance company for you, they pay a set amount, you may have to pay something, and we have to adjust the difference as a contractual agreement.  At Walnut Street Health & Wellness, we do participate in many major insurances.  But if you are questioning if we are covered - call your insurance company or log onto their website.  If we do not participate, we may be willing to, just let us know!


Second thing:  copays are due at the time of service.  This is usually a contractual requirement of your insurance company!  Plus, it saves us time and postage from billing you later and saves you time and postage for paying later!


Third:  Deductibles - an amount you may have to pay in addition to copays, usually are in effect at the first of the year.  For instance, if you have $100 deductible, you must pay the first $100 of services that the insurance company would have paid.  Once the deductible is met, the insurance company starts paying.


Fourth:  Co-insurance - many companies have an amount you must pay on services, even if your deductible and possibly copay have been paid.  One of the most common is lab services.  You may owe a percent of the charge.


Fifth:  Read thru your policy.  You don't have to read word by word, but at least be familiar with the normal coverage for services.  Then if you have to go to the hospital or have major tests - read it again!  You may be surprised to learn your insurance pays for something you did not know - such as 100% coverage on a yearly physical!


Sixth:  last thing, contact your insurance company.  If you question a denial or rejection, you can contact us, but many times contacting the insurance company will resolve the issue faster.  They can tell you about your denial, reprocess the claim, and/or get ahold of us to resubmit a claim.

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125 W. Walnut Street
Ogden, Iowa 50212
Phone:  877.424.9321
Fax:  515.275.2534


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