[{"@context":"https:\/\/schema.org\/","@type":"BlogPosting","@id":"https:\/\/reflexknees.com\/blogs\/customer-service-understanding-health-insurance-part-3\/#BlogPosting","mainEntityOfPage":"https:\/\/reflexknees.com\/blogs\/customer-service-understanding-health-insurance-part-3\/","headline":"Customer Service \u2013 Understanding Health Insurance, Part 3","name":"Customer Service \u2013 Understanding Health Insurance, Part 3","description":"  Previously on the Reflex blog, we discussed\u00a0out of pocket costs\u00a0and\u00a0preauthorization, as they relate to your health insurance coverage. Today we\u2019d like to cover another common question: Where should you turn when it comes to insurance questions?   While most people have a tendency to call the doctor\u2019s office, the most efficient route to immediate […]","datePublished":"2015-08-24","dateModified":"2024-01-09","author":{"@type":"Person","@id":"https:\/\/reflexknees.com\/author\/developer\/#Person","name":"Nick Petersen","url":"https:\/\/reflexknees.com\/author\/developer\/","identifier":2,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/8ea7fc410413ee0b715aee4c6b2d912c09623af5f85eaca6f6d7e0a2c223e1df?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/8ea7fc410413ee0b715aee4c6b2d912c09623af5f85eaca6f6d7e0a2c223e1df?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Reflex Knee Specialists","logo":{"@type":"ImageObject","@id":"http:\/\/b1ec2b6df7.nxcli.io\/wp-content\/uploads\/2023\/03\/logo.png","url":"http:\/\/b1ec2b6df7.nxcli.io\/wp-content\/uploads\/2023\/03\/logo.png","width":169,"height":104}},"image":{"@type":"ImageObject","@id":"https:\/\/reflexknees.com\/wp-content\/uploads\/2023\/06\/2517585.webp","url":"https:\/\/reflexknees.com\/wp-content\/uploads\/2023\/06\/2517585.webp","height":1536,"width":1536},"url":"https:\/\/reflexknees.com\/blogs\/customer-service-understanding-health-insurance-part-3\/","about":["Blogs"],"wordCount":571,"articleBody":" Previously on the Reflex blog, we discussed\u00a0out of pocket costs\u00a0and\u00a0preauthorization, as they relate to your health insurance coverage. Today we\u2019d like to cover another common question: Where should you turn when it comes to insurance questions? While most people have a tendency to call the doctor\u2019s office, the most efficient route to immediate answers is to contact your insurance company directly. In reality, your medical office serves as the middleman between the insurance company and its policy members \u2013 and (like the patient) is often waiting to hear back from the insurance company regarding claims processing and approvals. It can be difficult to navigate conversations with insurance companies, so we\u2019ve compiled some information on how and when to make the call. How to Make Contact On the back of your insurance card you\u2019ll find a customer service phone number designated specifically for members. These days, many companies have instituted automated phone programs that can help you check basic information \u2013 such as your deductible, out of pocket maximum, co-pays, or general coverage for in-network providers. If you need more detailed information (such as the status of a claim or pre-authorization), you\u2019ll need to request to speak to a representative directly. This same basic information can often be found on your insurance provider\u2019s website. Look for a website address on the back of your insurance card \u2013 many insurance companies have patient portals. Setting up an account login the first time you visit the website usually only takes a few minutes. Questions to Ask Your Insurance Company Ask your insurance company directly if you have questions about any the following topics:Whether a specific provider is in-network with your planThe status of a submitted pre-authorization (pending, approved, denied)Information regarding claims submitted to your insurance provider by any medical office you\u2019ve received treatment fromYour Explanation of Benefits (EOB), which details how much your insurance company will pay for services, and how much will be left for you to payBilling inquiriesRequesting a Summary Plan Description, which details the benefits, limitations and maximum for your planSpeaking with an insurance representative will help you to address these questions and clear up any confusion surrounding your plan. How Reflex Does Our PartAt Reflex, we try to make the insurance process as easy as possible for our patients. Here are some steps we take to help:We call and verify eligibility and benefits for all new patients scheduled for an initial evaluation.We provide a Reflex insurance specialist at the end of your appointment, who will review your insurance coverage for any new treatments recommended by your physician.We call insurance companies to verify coverage for patients scheduled for six-month follow-ups. In these calls, we determine whether your insurance company has made any changes to your policy. If so, we will notify you of these changes during your visit.If you\u2019re struggling with knee pain, insurance can often feel like one more obstacle in the way of relief. Don\u2019t let insurance questions overwhelm you \u2013 knowing your resources is the first step to finding answers and moving forward toward a pain-free life. If you are struggling with chronic or intermittent knee pain that is affecting your daily life, call to\u00a0schedule an appointment\u00a0with one of our specially trained physicians today at (503) 719-6783."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Blogs","item":"https:\/\/reflexknees.com\/blogs\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"Customer Service \u2013 Understanding Health Insurance, Part 3","item":"https:\/\/reflexknees.com\/blogs\/customer-service-understanding-health-insurance-part-3\/#breadcrumbitem"}]}]