Do You Know Your Benefits?
August 31, 2016
Have you received a medical bill, but don’t understand the charges and why you were billed? Medical billing is complex and different for each plan. ARC and Texas Medical Association (TMA) share some tips below.
Understanding Your Benefits, Better
We receive many questions about medical bills that patients assume are covered by their insurance plan. We encourage you to learn about your insurance benefits before your visit to avoid the surprise of being billed for expenses you do not expect.
We wish we could easily inform you of the cost of a service or procedure while you are in the exam room. We wish everyone’s benefits were loaded in a large database that would alert us to your costs at the time of service. We know that is what you want too. Unfortunately the health insurance system is complex and out of our control. Since we accept over 50 different insurance plans, our doctors and nurses cannot know the details of each plan.
So, what can you do? Here are a few tips from the Texas Medical Association (TMA) guide that help you better understand your insurance benefits:
- Understand what your plan covers and does not cover. Health insurance plans don’t cover every type of care a patient may get from a doctor.
- Know your deductible amount and your out-of-pocket costs. That’s how much you have to pay first, each year, before your insurance starts to pay something towards your health care costs.
- Know if your doctor is “In Network.” Insurance companies save money by limiting which doctors and hospitals they include in their networks.
- Call your insurance plan to confirm benefits. Insurance companies generally decide for themselves how much they will pay doctors for specific care.
- Talk to an ARC financial counselor before a planned procedure or surgery.
If you have any questions regarding your bill or would like your account balance, you can contact ARC Customer Service:
- Call toll-free at 1-844-632-2073
Monday - Friday 7:00am – 9:00pm
Saturday 8:00am – 1:00pm
- Send a secure message Online
- Use the [Ask Customer Service] link in your ARC MyChart messaging center
Please include the information below in your message:
- patient name,
- best phone number to reach you, and
- patient account number.
To navigate the many confusing insurance issues, we recommend the Texas Depart of Insurance online resource - Texas Health Options website.