Table of contents:
“navigating The Health Insurance Maze: Tips For Successful Approval And Claims In Australia” – NEW 9TH EDITION! Book: Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance – And Whether You Should (click for details)
You’ll have the choice of getting just the digital PDF copy (so you can read the book right away on your computer or smartphone), saving you $18.75 including tax and shipping, or getting both the digital and paperback versions.
“navigating The Health Insurance Maze: Tips For Successful Approval And Claims In Australia”
Newly updated and applicable nationally, this book is packed with information you never learned in high school about running your business and working with insurance. It guides you step-by-step and answers all your questions about working with insurance—even if you never sign an insurance contract, since even out-of-network therapists can get their superbills and documents reviewed by health plans. With a sample claim form and instructions and helpful handouts and resources, you’ll have all your insurance questions answered. Topics include:
Sp Join Plans 3/21, Get Started With In 3/22; Insurance 101 7/23 Landing
Easy to view: The digital PDF version requires no technical skills or special programs to watch – after purchase, you will be sent an instant link. With one click, you can view it on your computer or smartphone.
WHO SHOULD READ THIS BOOK: The book is aimed at a national audience of mental health providers. It is intended for out-of-network and in-network physicians and therapists trying to decide if insurance is right for them. It is appropriate for psychologists, mentors, students, counselors in training, accountants or mental health clinic staff.
BONUS FOR CALIFORNIA THERAPISTS: 7 CEUs are available to LCSWs, LMFTs, LPCCs and LEPs in California after reading the book and taking a short post-exam. Other licensees should check with their licensing board about possible credits. The CE exam must be purchased separately at www./store.
IMPORTANT: AFTER PURCHASE, KEEP LOOKING AT THE SCREEN — YOU SHOULD IMMEDIATELY SEND A REFERRAL TO THE “THANKS PAGE” — SCROLL DOWN THE PAGE AND GENTLY CLOSE THE LITTLE BLUE LINK ON THE PDF GIGI BOOK. IF YOU CHOOSE the paper version, it will be sent via priority mail. We will send a follow-up email with the link within one business day to ensure you have received the pdf link. If you do not receive this email please check your spam folder. Contact us at orders@ if you do not receive it within 1 business day or with questions.
Trying To Navigate The Cold, Confusing Health Insurance Maze
Note: Be sure to select one of the options below when asked “which book version would you like?” BOSTON – Even a self-proclaimed data geek like Peter Kim was almost undone by his search for health insurance.
Mr. Kim left the corporate world in 2005 to become an independent consultant, losing employer-sponsored insurance for his family of four. But researching individual health plans proved incredibly complicated, he said. And most were too expensive, to boot.
“It was impossible to compare plans,” said Kim, 42, who lives in Cambridge. “I eventually gave up trying.”
He and his wife resorted to panic coverage, paying out-of-pocket for routine medical care — until they discovered the health insurance exchange that Massachusetts set up in 2006. Short of the state law enacted under Mitt Romney as governor, which requires most residents to have health coverage, the exchange is an online marketplace designed to simplify buying insurance, helping people find a plan they can afford.
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If the Supreme Court upholds President Obama’s federal health care law in a decision expected this month, advocates say the exchanges will be an important tool for extending coverage to most Americans. Debate over the law has centered on the individual mandate, the lightning protection provision that requires most Americans to have health insurance by 2014.
The law requires each state to come up with an exchange, but many are arguing, complaining about everything from cost to perceived federal interference. Some, like Louisiana and Maine, refuse. Others are delaying major decisions until the court rules and the November election. So far, only about 15 states and the District of Columbia have implemented exchanges, with California and Maryland the furthest along in planning them.
Mr. Kim’s experience in Massachusetts, which along with Utah is one of only two states with an exchange program, shows how the exchange should ideally work. After just an hour of research on the exchange’s website, he says he found a better deal. He enrolled in a plan through Harvard Pilgrim that pays $1,086 a month for his family.
The exchange, called the Health Connector, has been operating since Massachusetts passed its own mandate in 2006. Despite all the criticism leveled at the state’s health care plan in this year’s Republican presidential primary, the work has received remarkably little attention. of the law.
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Even if the Supreme Court strikes down the federal mandate, many believe some form of exchange could still be crucial to expanding coverage in many states. In Massachusetts, insurers offer to join the Connector — offering plans that include some form of hospitalization, prescription drugs, maternity care and other services the state deems necessary — and the Connector uses its market influence and unique guidelines to promote innovation and competition among them.
“It can—and has—helped people find more affordable options than they otherwise knew existed,” said Connector CEO Glen Shor.
But for all the pleasure Mr. Kim, Connector officials admit they need more consumers like him — full-paying customers who don’t qualify for government subsidies to offset their premiums. So far, the program has drawn only about half that population to the state’s individual markets, according to Connector officials.
Instead, approximately 82 percent of the approx. The 224,000 people covered through the link have low enough income to qualify for state and federal subsidies. They pay a modest premium or nothing at all. This is precisely what many opponents of stock exchanges fear, that instead of a free market, they will become something resembling a large-scale public welfare program.
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The link has struggled to attract another key component of the health care overhaul effort — small businesses, which have long complained of being priced out of the health insurance market.
The Health Connector has been operating since Massachusetts passed its own mandate in 2006. Credit… Evan McGlinn for The New York Times
While Massachusetts law requires many small businesses to offer insurance to their employees or pay a fine, many have seen no incentive to buy insurance through the link, said Joshua Archambault, director of health policy at the Pioneer Institute, a conservative think tank here. . About 1,700 small companies now insure a total of 4,320 people through the link – just a minute fraction of that market.
Mr. Shor said the Connector is taking steps to attract more small businesses, this year adding more “popular, brand-name” insurance companies to its small business options, including Blue Cross Blue Shield of Massachusetts. It also added a health program that allows a 15 percent discount on the employer’s share of premium costs if certain conditions are met.
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Amy Whitcomb Slemmer, executive director of Health Care For All, a Boston advocacy group, said she is concerned about the number of unsubsidized plan customers — 52 percent of them — who choose so-called bronze plans, which have the lowest monthly premiums. These plans tend to have high deductibles (up to $4,000 for a family) and out-of-pocket maximums that mean people who get sick often end up paying a lot.
“We’re increasingly concerned about high-deductible plans that seem like a short-term fix for people,” Ms. Whitcomb Slemmer said. “We spend a huge amount of time helping people understand the risks they are taking.
For Andrea Cunningham of Watertown, the bronze plan was the most viable option. She quickly found coverage for her family of three through Connector after her husband lost his job in February. Sitting at her dining room table with a laptop, Ms Cunningham, 30, entered her and her husband’s ages, their zip codes and the number of people in the family. Within seconds, her options—several dozen plans in all—popped up.
The best part, she said, was how simple it was to compare the standard plans — how much each charged in copayments for prescriptions, doctor visits and hospital stays, for example. “It was super easy to look and figure out what price range we wanted,” she said, “and then dive deep into one or two of them.
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She opted for a bronze plan, for which she and her husband, who is still unemployed, pay about $900 a month.
The vast majority of people who have gotten insurance through the link since the recession began haven’t had to worry about deductibles because they qualify for subsidized coverage. In that plan, the big challenge has been keeping costs down as enrollment has steadily increased.
One strategy has been to reward the lowest-cost insurers in Commonwealth Care, the subsidized plan, by driving customers to
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