People today have a lot of choices when it comes to how, when, and where they receive healthcare. Options are great until they get overwhelming. How do you consider these options and walk away a savvy healthcare consumer? We’d like to offer a few suggestions:
UNDERSTAND THE PROGRAM
As you consider various healthcare options, make sure that you read carefully and understand the services being offered. For Zion Healthshare members, our go-to document is our Member Guidelines which represents the “rules of the road” in navigating our services. We have worked to keep things simple, but it may still feel a little daunting, especially as health shares are a paradigm shift for many people. We also use specific words to emphasize that we are a cost-sharing community and not insurance.
A few examples: Shared = What you don’t have to pay for; Need = What you want help paying for; and Member Responsibility (or IUA) = What you pay before we pay. Any time that you are unclear about something, be sure to give us a call. Our average wait time is only 20 seconds!
SHOP AROUND FOR HEALTHCARE SERVICES
Don’t assume that your neighbor or doctor always knows the best options for your medical need. Hospitals often charge more for services like laboratory testing and CT scans compared to outpatient clinics. Surgery Centers can also be much more affordable for specific procedures than traditional hospitals. It’s important to recognize that a higher price does not always equate to higher quality. At Zion HealthShare, our Medical Advocacy team has access to several online tools to help you find the highest quality provider at the most affordable price. We have also partnered with Savvos Health, a company that has created the largest marketplace of affordable cash prices. Together we can not only help you find the right provider but can help to schedule the procedure and arrange for immediate payment. Transparency in pricing is one of the strengths of choosing a healthshare.
DON’T BE AFRAID OF THE FINE PRINT
After you have gone to your appointment or after a procedure, be sure to get an itemized copy of your bill. You will need this when completing a need request. It’s also good practice to make sure that you were billed correctly. When you receive an EOS (Explanation of Sharing) from Zion HealthShare, compare it with your bill to confirm that you were billed correctly. Itemized bills contain detailed descriptions that can help you argue unfair or incorrect charges. According to the Medical Billing Advocates of America, up to 80% of medical bills contain errors! Our Member Care team can help you with any questions relating to your EOS.
KNOW WHERE TO GO
Research shows that over 17% of ER visits are unnecessary, which adds up to $4.4 billion in avoidable costs. It can be a tough judgment call to make if you are feeling extremely ill, but consider that for more immediate or after-hours care, an urgent care clinic could be a great solution. Many of them are open seven days a week, have far shorter wait times than an emergency room, and cost less than a traditional hospital emergency room visit. For members who are enrolled in Teladoc (Direct member and Essential members who have opted in), there is 24/7 access to board-certified doctors via the phone or online web conferencing. This is often a great no-cost option for non-emergency situations.
TAKE GOOD CARE OF YOURSELF
Finally, becoming a better healthcare consumer starts with you. Think about how you take care of your body and mind, and how it affects your healthcare spending. Eating healthy, getting regular exercise, and reducing stress are all very important to your overall health and wellness in the short and long term. You may be surprised to learn that according to the Centers for Disease Control (CDC), up to 40 percent of annual deaths from each of five leading causes are preventable! They are heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries. Many of these risks are avoidable by making changes in personal behaviors.