Three Ways To Stand Up To The Health Care System And Control Costs
Our current health care scheme expects patients to shop for care and haggle with insurance companies over covered services. With little price transparency and barriers that keep patients from intelligently negotiating costs and coverage with providers, controlling costs as a patient is mostly a fallacy. Our only option at this point is to force change by standing up to the health care delivery complex. I share three ways to effect change in our system, get better care, and hopefully control your health care costs.
Always insist on in network providers
It has become a huge problem – no matter how hard you try, some service you receive is going to involve out of network coverage. Often the insurance company refuses to pay the bill and the out of network providers charge way more than the going rate. What can you do to prevent this?
If you have a planned procedure, verify again and again that everyone involved is in network. Labs, pathologists, anesthesiologists, and other consulting physicians may not be in your network even if the hospital where you receive care is part of your network. Out of network bills can mount quickly and may not apply to your deductible.
The book “An American Sickness” by Elisabeth Rosenthal shares many great pearls on how to challenge the system. My favorite for preventing out of network care? Write on any financial responsibility form you are asked to sign that you will only accept in network care. I would add to the form, “It is your responsibility to ensure that all care I receive is covered in my network.” Take a picture of the form and ask for a copy. You can use this to fight the system later if needed.
Take control of your medical records
Good medical records should tell the story of your health care life. It is estimated that 83% of illness can be diagnosed on a good history alone. Unfortunately, doctors see a high volume of patients and now have little time to let you tell your story. In their rush, they can unintentionally railroad you into an incorrect diagnosis.
Electronic medical records are a joke. Documentation of useless quality of care measures, unnecessary data to support billing, and massive “fluff” to guard against lawsuits results in massively long records that mean absolutely nothing to your health. This glut of data impedes doctors from digesting what they need to know to provide the best care. An innovative way to get the care you need and to control cost is to create your own medical record.
How do you do this? You shouldn’t have to do what I am getting ready to suggest, and since our system has become inefficient, often dangerous, and seriously fragmented, it is important for you to create your own medical record. First, when you make an appointment to see your doctor, type out your history. What symptoms are you having? What have you been doing to help your symptoms? How long have you had a problem? Basically, tell your story from beginning to end.