Dec 15, 2006
From a press release . . .
If they were really concerned with "transparency", they would show how much of the bill "they" cover. This article looks like it was released by their PR dept.
I think John pointed out once that there is a hugh difference in the cost of a procedure done at the Mayo Clinic vs the same one done at "Any city" general hospital.
Transparency means nothing unless you can somehow create a system that consumers can judge quality of care. I doubt that many of the general population don't understand the price is higher at a Mayo Clinic Vs General Hospital. What they are truly in the dark over is the true sense of being able to judge Quality of Health Care between the two.
Oh I am certain this is from their PR dept. None of the information is surprising, but it is interesting none the less.
If Healthmarkets wants to take that road then whenever an agent tries to sell a R&B plan they should also show the clients the average R&B rate in that state. Don't think that's gonna happen. Maybe when Healthmarket agents sell a plan that caps chemo they can show the client a chart that shows the low and high cost of chemo. Then let's see how many plans they sell.
I replaced another Midwest plan yesterday, and I couldn't believe my eyes!
The agent sold her a $300 R & B max benefit!! OMG!! I told her it is 5x that here in Colorado! She bought it 2 years ago, I'm sure it's gone up that much since then!
But hey give the Midwest agent credit, he set her stop loss at 75K!! LOL!!
She also told me she tried calling her agent, who told her quote, "I don't deal with policy customer service issues, you need to call the company for that!"
Sometimes I feel bad for consumers!
As an agent exactly what kind of problems can you help her with?
I do it all the time....from getting claims resubmitted to advising on policy changes....
I had a client who had a claim denied a few weeks ago. She had a rider for excema. No problem. But she went to the doctor for allergies which was fully covered. While at the office the doctor merely ASKED her how her excema was doing and she said fine. When he submitted the bill however he put the diagnostic code for excema. Maybe it was a mistake and maybe the doctor got paid more. Who knows. Anyway, I had my client call the doctor to get the records for that visit faxed - which proved the actual visit was for allergies. I faxed that to the company who paid the claim.
That's what you can do.
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