Posts Tagged ‘preferred provider organization’

Saving Money With Health Insurance

June 4th, 2010

Everyone likes to save money and your health insurance is a place where you can find savings. The easiest way to save money with health insurance is to only insure yourself for large, catastrophic medical problems or to increase your deductible in order to decrease your monthly premium. Both of these choices might not be the best health insurance option for everyone because each will increase your out-of-pocket medical expenses for everyday medical care and preventative examinations.

There are a number of tips to keep in mind beyond increasing your out-of-pocket expenses to minimize your health insurance costs while receiving the health insurance coverage you and your family needs.

Here are six things to consider for saving money through your health insurance:

1) If you are part of a health insurance plan such as a POS (point-of-service) or PPO (preferred provider organization), make sure you only use doctors and medical services that are in-network for your plan.

2) Take every tax deduction offered on health insurance. For the self-employed this means deducting all your health insurance premiums, and for participants in employer-based plans deducting the portion you pay of your health insurance premiums. And medical and dental expenses you incur that your insurance doesn’t cover that exceed 7.5 percent of your adjusted gross income (AGI) can be deducted as well.

3) When you are comparing health insurance quotes take a look at the long-term implications of your plan. Lower health insurance premiums and up-front costs will mean more out-of-pocket expenses and possibly much higher medical costs over the long run. Consider how you expect to use your health insurance and factor all the costs when comparing health insurance quotes.

4) Don’t make visits to the emergency room unless you are experiencing an actual medical emergency. The co-pay will likely be very much higher than for a regular office visit.

5) If possible participate in employer- or other organization-based group health insurance. The rates and qualification requirements are typically lower. If you are part of a employer-based group health insurance plan have your employer pay the premium on a pre-tax basis to lower your overall taxable gross pay. Another way to reduce your taxable income is to participate in your employer’s flexible spending plan to save money for out-of-pocket health insurance expenses such as co-pays, some medications and certain medical devices.

6) Save money on health insurance prescription medication by using online pharmacies. Traditional pharmacies will typically dispense only a 30-day supply of medicine while online pharmacies will allow for 90-day supplies for the same co-pay.

Hamilton Plans Contract Discussions Next Month With Four Large Insurance Companies

June 4th, 2010

Hamilton Health Care System and Blue Cross Blue Shield of Georgia have reached an agreement to provide health care services for the University System of Georgia.

The agreement will allow any of the 50,000 employees and retirees of the university system, including those at Dalton State College, to receive care at either Hamilton Medical Center or Murray Medical Center as part of Blue Cross’ preferred provider organization (PPO) network. The agreement will also mean university employees and retirees will have access to more than 200 physicians in the area, according to Blue Cross.

In a statement, Blue Cross said Hamilton placed talks to cover all of Blue Cross’ PPO customers on hold on July 14. But Hamilton and Physicians Health Services, which represents almost all of the area’s doctors, say they will begin negotiations next month with Blue Cross and other major health insurance companies that may bring the hospitals and local doctors into those companies’ PPO networks.

“We are planning to start having language discussions, contract language discussions next month,” said David McCreery, president of Physicians Health Services. “That is the first step. Depending on how quickly they are willing to move on that, we are ready to proceed with at least the four major players in the marketplace.”

McCreery says those companies are Blue Cross Blue Shield, United Healthcare, Aetna and Cigna, the four largest health insurance companies nationwide.

“We plan to actively contact them, not just sit back and wait on them to call us,” he said.
Hamilton, and many local doctors, do not currently accept those major plans.

“We want the community to know we have heard the community’s request to access our services through a wider variety of insurance plans, and we are working hard to extend our relationship with Blue Cross and other national insurers,” said Hamilton CEO John Bowling.

Will having reached an agreement on university employees make it easier for Hamilton and Blue Cross to reach an overall agreement?

“Blue Cross and Blue Shield of Georgia has approached the two discussions independently of one another and does not feel that one discussion will impact the other,” Blue Cross said in the statement.

Bowling says that the university agreement might make it a bit easier since each side is now more familiar with each other’s concerns.

“The caveat would be that this is a Board of Regents matter. Therefore, they control it, not Blue Cross. Blue Cross just serves as a third party administrator. Blue Cross is not the payer there, and where Blue Cross is the payer, there’s likely to be some different contractual language,” he said.

Hamilton and Physicians Health Services say clinical integration — developing a common set of clinical protocols for all physicians — will be key to contract negotiations. They had set a deadline of July 31 to complete that process.

“The plan was to try to do that. It was really a deadline requested by the Chamber of Commerce. We are running a little behind that schedule. There have been some unanticipated difficulties with the information systems of the physicians,” said McCreery. “But we have made a lot of progress. We are getting real close to saying that we are clinically integrated. We’re trying to make sure the difficulties we have encountered don’t slow down our ability to engage in the contracting process.”
In April, several local business leaders sent a letter to Bowling asking for local health care providers to take part in a larger number of health insurance networks.