LINK: i don’t know what i don’t know
Currently listening to: Somebody That I Used To Know – Gotye feat. Kimbra
You can get addicted to a certain kind of sadness
Like resignation to the end, always the end
So, when we found that we could not make sense
Well, you said that we would still be friends
But I’ll admit that I was glad it was over
What has your experiences taught you about the healthcare system?
Prompt created by yours truly.
Feel free to use any prompts for August that I post and/or tag me.
I’d love to read your responses
The healthcare system is a maze and there’s no one helping navigate this ginormous system of care for anyone. Including myself. Don’t even get me started with the in-network, out-of-network, deductibles, co-insurance, prior authorizations, and what not.
People can go to a local hospital that is in-network with their insurance and have an operation by an in-network surgeon but can get a nasty bill because the anesthesiologist is an out-of-network provider. The No Surprises Act was supposed to clear this confusion for people but if you don’t know about it, how can you push back?
Just because a physician orders a medication doesn’t mean that you’ll be able to get the medication, especially if it’s a non-formulary—meaning that it’s not the cheaper, usually prescribed drug. To get the newer and often times more costly medication, paperwork needs to be completed to justify why that particular medication is needed. This could take days to weeks for the health plan to respond back and often times, there is a lot of back and forth between the doctor’s office and the insurance.
Most non-profit hospitals are required by law to offer some type of temporary financial assistance. People don’t really know about it unless they specifically ask. Whenever I have a patient who tells me about their financial constraints, I’m quick to give them the number to call to see if they are eligible (family income at or below 400% of the federal poverty guideline and high medical costs).
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