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Insurance Transparency Would Benefit Patients Most

February 22, 2015
Posted By: Dr. Adam Singh

This piece was picked up by the Middletown Press. The unedited content is below. 

The Affordable Care Act (ACA or Obamacare) has done well to be inclusive of non-insured citizens as it transforms the healthcare landscape. There is a lot of good that has happened. There have also been some significant shortcomings that need to be addressed. While taking on millions of previously uninsured citizens onto federally funded programs, no tangible steps were taken to insure that people would have providers. We get three times as many calls into our office asking whether we take a particular federally subsidized plan. The fact that the insured have no idea where to go for care and how much it will cost is still a big concern.

This past week, our office called a private insurer and asked them to fax over benefit information. We've found insurers respond more with requests from patients than providers. We had the patient right there and asked her to get on the phone to facilitate the process. The request was denied to us and the patient. The insurer would not fax over the information or email it. The patient would have to go home, sign on to a website and see what she could accomplish on her own. We still have difficulty from insurers providing definitive answers regarding coverage. Some insurers send over information over fax after a two minute phone call. Others have us wait hours on hold before they tell us they will not give us the information. This is counter-intuitive to the transparency and efficiency which should be the goal of every party involved in healthcare.

Perhaps there is a way to address the needed change. In the meantime, we are encouraging all our patients to be more proactive with getting their benefit information in-hand either through the insurer or through the HR department at work. 


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