I work for an oncology office in Georgia (USA). In case you are not familiar with oncology, it is the specialization of medicine which focuses on the care of cancer victims. I happen to work in an office that provides chemotherapy as opposed to radiation treatments although these two methods are not mutually exclusive. My job is insurance verification. It is my role to call various insurance companies and determine what sort of coverage is offered for what sort of services. Although all medical practices from major hospitals to private practices have personnel to verify coverage, not all practices have personnel who do that as a singular role. The extreme expensive of providing chemotherapy and the necessary related services in an office setting led my office to employee myself and several other persons for this sole purpose.
Here are a few things I have realized in my role as insurance verification specialist...
1) Doctors make a great deal of money.
2) A doctor's office is not a charitable organization because it cannot be and still keep its doors open.
3) Insurance companies are businesses not non-for-profit organizations because they have stock holders and employees and
CEO's that want to make money.
4) Drug companies have a great deal of say in whatever they care to have an opinion about.
Now, I will gladly discuss any of the above points in another thread, but the actual purpose of this thread is to discuss how the government or any useful organization might go about educating the public about insurance. See the points below.
5) People pay a great deal of money for insurance without even knowing what it covers.
6) People think that one type of insurance is the same as any other.
7) People have no idea of how much healthcare really costs.
Of course the three points immediately above do not apply to everyone, but I find that they apply to a much larger number than they should. I verify coverage every day; so, I know a great deal more about it (locally speaking) than any healthy person should. However, everyone should know the difference between a HMO, POS, and a PPO. Everyone should know what a referral or precertification requirement is. And most importantly of all, everyone should know about pre-existing clauses. If you don't know and you want to, then I will be glad to explain how they work locally and in the majority of America, but what I really want to know is how to go about making the general public aware of the importance of understanding how their own health insurance works. How do we make them really understand how it functions and what its requirements are? It is just unconscionable how patients continually waste money when they could recieve quality care and quality coverage.
