As your patient's practicing physician or dentist, you are aware of their real and immediate medical needs more than any other medical professional out there. Therefore, you can use this page to give answers to questions that seem to pop-up regularly from your patients and/or you can simply provide answers to questions that you think may be of concerns to your clients even if they don't ask you those questions directly. FAQ has become standard to all great websites. No information-based business in its right mind would have a website without an FAQ page.
Creating your FAQ with iNTELLESIS is very simple. If you don't already have a file or brochure that has your FAQ, we could help you make one when inputting your information into this template for the first time. You can even dictate your content over the phone as one of our administrators type it directly into your website. Isn't this great?
What is Free-for-Service plan?
Under a typical
Fee-for-Service plan, the doctor or hospital
will be paid a fee for each service rendered to
the patient. In other words: You go to the
doctor or hospital of your choice and you (or
your doctor or hospital) submit a claim to your
insurance company for reimbursement. You will
only receive reimbursement for the "covered"
medical expenses listed in your
policy.
More about that
reimbursement
When a service is covered
under your policy guidelines, you will be
reimbursed for some -- but rarely all -- of the
cost. How much you get depends on the specific
policy provisions, on coinsurance and on
deductibles. How does it work?
- The portion of the
covered medical expenses you pay is called
"coinsurance." There are some deviations, but
usually Fee-for-Service plans reimburse doctor
bills at 80% of "reasonable and customary
charges" -- in other words, the prevailing cost
of a medical service in any given geographic
area. Who pays the other 20%? You do. That
amount is your
coinsurance.
What if charges are
higher than "reasonable and
customary"?
This is where things can get
sticky ... and not just from a bandage that
needs changing. If you are covered by a
Fee-for-Service plan and your medical provider
charges more than the reasonable and customary
fee, YOU will have to pay the
difference.
What about
hospitalization?
Some Fee-for-Service
plans pay hospital expenses in full. Most,
however, reimburse at the 80% level as described
above. (Lesson? Read your policy
carefully!)
So what, exactly, are
"deductibles"?
A deductible refers to the
amount of covered expenses you must pay each
year before the insurer starts to reimburse you.
It goes something like this:
Let's say
you have a $300 deductible
The first time you visit
a doctor, you are required to pay the cost of
the examination: $110. Several months later,
your doctor recommends that you have your
cholesterol and triglycerides checked. You go to
the lab, have the blood drawn and pay the lab
fees: $80. You return for the results of your
tests and your doctor tells you you're healthy
as an ox. Then he sends you away with a pat on
the back and a bill for another $110. At this
point, you have met your deductible of $300.
After that, your insurer will reimburse you for
each doctor visit or hospital stay - usually
80%, as mentioned above.
Deductibles
vary. A typical deductible is $250 per person,
but it can be lower or much higher. Some folks
opt for a deductible as high as $10,000 (that's
right, $10,000) to reduce premiums or to be used
in conjunction with a medical savings account.
The maximum family deductible is usually three
times the individual deductible. As a rule, the
higher the deductible, the lower the
premiums.
Wait a minute ... what are
"premiums"?
Premiums are the monthly or
quarterly payments paid for health insurance.
They don't count toward
deductibles.
Keep a few things in mind
about Fee-for-Service
plans
Fee-for-Service policies typically
have an out-of-pocket maximum. This means that
once your covered expenses reach a certain
amount in a given calendar year, the reasonable
and customary fee for covered benefits will be
paid in full by the insurer. If your provider
bills you more than the reasonable and customary
charge, however, you may still have to pay a
portion of the bill.
You may have
lifetime limits on the benefits paid under your
Fee-for-Service policy. Look for a policy whose
lifetime limit is at least $1 million. One major
illness or extended hospital stay could easily
use up a smaller lifetime limit, and nothing is
worse for your healthy recovery than worrying
about medical bills.