USA - An expert on how to get what you need from your health insurance - Ask A Manager

[Alvin2]

An Ask a Manager reader who works in health insurance as a customer service trainer wrote to me and offered to give advice about navigating health insurance, saying, “Basically, I get paid to learn and teach how to beat the system as much as possible. I love my job as much as I hate this industry and system, so I’m always game to help people out and answer questions … I teach customer care reps, so I’m teaching them the rules, why things happen like they do, and then how to find the wiggle room and exceptions so that we can actually take care of providers and consumers. That looks like things we can do within the insurance itself like adjusting claims or nudging consumers to ask for reviews of denied prior authorizations, to reaching out to provider billing offices to mediate billing issues. There’s also a lot of explaining, educating, and directing to resources (in the company like our in-house care management, as well as externally like EAPs or community resources).”


I said yes, we want her tips! She put together this Q&A to help people.

https://www.askamanager.org/2021/05/how-to-get-what-you-need-from-your-health-insurance.html

Its a long read but very interesting. Also tough for us to get through with our cognitive dysfunctions, my apologies on that one.
Also the poster is answering questions in the comments, and you don't need to register to ask questions, just choose a username.
The comments are usually open for a week but often after the first few days things die down so if you have any questions put them together and ask in the next day or two.

 

[lenora]

Thanks@Alvin2.....Advice like this is always helpful. I know many people on this BB can use it. Notes on particular subjects can be always be made. Thanks! Yours, Lenora.