Medical Insurance Managers: Have your insurance handled properly by your practitioner

Armen Hareyan's picture

Learn how to manage your own insurance. It's easy, as all you have to do is follow the rules. Call your insurance company to find out the details of reading your statements.

Through various debacles in which I have been involved as well as interviews I have taken over the past five years, the medical community isn't what it used to be. Medicine has turned from civilized medical assistance to ham-fisted avoidance of responsibility in the hopes of turning a higher profit. Although a few doctors still remain who are willing to function as pure medical practitioners, the remainder practice aimlessly behind the protected political wall of shame.

Just as a quick note, have you ever wondered why some doctors, in the same specialty, charge ridiculous amounts of monies and other charge within a reasonable range? There are various fees and specialty charges that you absorb as a patient; however, the largest fee that you are paying for is their liability cost.

From many doctors with whom I have spoken over the past two years, a practitioner's fees are usually higher if they have a higher rate of incident or reporting by their patients. Although your insurance company does have negotiated fees and contracts with these practitioners, indeed, the excessive costs are reflected back to you by way of increased premiums or out-of-pocket expenses. However, you are not responsible to pay for their mistakes and mishaps over the years.

Here are just a few things that you can do to ensure proper handling of your claims:

* Monitor your deductible and out-of-pocket expenses.


* Call your insurance company to find out the details of reading your statements.

Obtain the details of any procedures or tests that you must undergo from your practitioner and call your insurance company to ensure that your practitioner's staff has called and to find out the details of coverage. If you're not satisfied or find that there is preferred provider from your insurance company, notify your practitioner immediately. Realize that some practitioners do receive kickbacks by referring you to a particular person, so ensure that you are getting proper care and insurance coverage regardless of how it affects your practitioner's income.

* Ensure that your practitioner is on your insurance company's preferred list. If not, find another practitioner.

Don't simply allow your doctor to call and manage your medical insurance. Many insurance managers in many clinics, offices, and hospitals are untrained in handling insurance verification and claims. In many cases, your out-of-pocket expenses will be surprisingly high because of inept actions by your practitioner's staff. You are paying for your insurance and deserve the most coverage possible, regardless of the lack of training by your practitioner's staff.


Edward B. Toupin is an author, publisher, life-strategy coach, counselor, Reiki Master, technical writer, and PhD Candidate living in Las Vegas, NV. Among other things, he authors books, articles, and screenplays on topics ranging from career success through life organization and fulfillment. Check out some of his recent print and electronic books as well as his articles covering various life-changing topics. For more information, and to find out about his upcoming title on book publishing, e-mail Edward at [email protected] or visit his site at

Copyright (c) 2004 Edward B. Toupin
This page is updated on April 24, 2013.