2012 > July

Monthly Archives: July 2012

Simplee’s Automatic Error Detection Saves Users Thousands of Dollars

Have you had a chance to check out Simplee’s error detection feature yet?

We’ve been hearing from many users about how they’ve saved money or solved billing problems.

First, there was the user who told us he fixed a billing problem in ten minutes, after fighting his insurance company about it for the last four months.

Another user tweeted that he found an error that saved him $1,000.

And then, we interviewed another user who saved over $1,000 on several medical bills just by checking for errors. He said this didn’t even count another several thousand he saved by repeated calling out a separate error: His insurance company denying every claim because it believed he and his family had a second insurance plan that should be paying.

Using Simplee has made it easy for him to spot this error, plus additional ones such as duplicate claims or the incorrect insurance carrier being billed. He then uses Simplee’s notes feature to track the status of claims he’s disputing, so he knows not to pay them yet.

So far, he’s found that over 70% of the claims for himself, his wife, and two kids, contained some kind of problem that needed to be addressed before he paid the final bill.

To review your own account, log in to Simplee and look for our red, orange, and green flags next to a claim. These flags will tell you when we think we’ve spotted a problematic claim or a tip for saving money.

Do you have a success story about using Simplee? Let us know! Your tips could help other members save.

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Tricks to time your health care to get the most out of your plan

Just about every health plan has features that are tied to the calendar year: deductibles, annual benefit limits, and FSAs (Flexible Spending Accounts). And through just a bit of planning, you can save a lot of money on health care.

It’s all about timing. Try these tricks for getting the most out of your benefits.

Go on a deductible-spree:

Once you’ve met your deductible, it’s a good time to get any major, expensive services as well as other routine or elective care. That’s when your plan will pay out its full benefits. If you meet your deductible mid-year, try to plan any other health care services for that year. Waiting until the following year means you will have to pay the deductible all over again.

Watch benefit limits:

If you are getting repeating services – such as physical therapy, counseling, or chiropractic visits, don’t lose track of how many you’ve received. Many plans have an annual limit so stay within this number and know when the benefits roll over.

Get Free Dental Benefits:

Dental plans that offer free check-ups and cleanings usually use one of two methods to calculate your benefits: the calendar year or every 6 or 12 months. Find out what the rules are for your plan, and then pay attention—you know your dentist likes to send out reminder postcards and that Simplee will email you about unused benefits. Don’t ignore these!

Also keep in mind that some dental plans cover procedures up to a dollar maximum for the year. If you are close to reaching the max near the end of the year, but still need a root canal, you might want to wait until the next year for better coverage.

Spend down your FSA: Flexible Spending Accounts are use-it-or-lose it at the end of the year. Most turn over at the calendar year, but some plans use a fiscal or academic year. Make sure you know the date your plan renews, and spend down your account in time. If you find yourself with a large balance near the end of the year, you can always stock up on staples such as bandages or contact solution.

Do you have more tricks that you’ve used to squeeze the most out of your plan? Share with us!

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Health Premiums Might Rise. But You’d be Buying Better Stuff.

There are a lot of rumors and stories about health insurance premiums rising because of the health reform bill. Are they true?

The short answer is, it depends on who you are, and no one really knows. But some new rules will keep your premiums from exploding in cost, while also providing better coverage.

If you have employer coverage, it’s hard to say. Some think employers might stop offering health insurance and instead let their employees buy their own on the health insurance exchanges—which could be more expensive–or could be cheaper, depending on the employer.

If you have individual coverage and a pre-existing condition, you’ll probably see your premium decrease.

If you have individual coverage, and you’re pretty healthy, you might see your premium increase. But not simply because insurers want to raise prices—because your coverage will be better.

Here’s why: Right now, most of the health plans that exist are not up to the standards of the plans that will be offered in the health insurance exchanges in 2014—the place where most people will be shopping for coverage. The cheapest, most minimal plan that will be allowed in the exchange, a bronze plan, is better than the average plan offered right now.

So if you currently have the super-cheap plan, in 2014, it probably won’t be offered in the exchange. The lowest level plan will likely cost more than that super-cheap plan, but it will offer better coverage. And that means lower deductibles and cost-sharing for you (Remember, premiums aren’t the entire picture—what good is a health plan if you pay for it every month but you’re constantly paying out-of-pocket?).

So that’s one way health reform might increase your premiums. But there are also some ways it might hold them down:

First, almost 60% of people who will purchase insurance through the exchanges will be eligible for a subsidy. If you earn less than 400% of the Federal Poverty Line ($44,000 a year for an individual, $88,000 for a family) you’ll qualify for a sliding scale subsidy.

(How much? Punch your info into this Subsidy Calculator to see what you’ll get.)

Second, another part of health reform prohibits insurance companies from raising premiums by more than 10% unless they can justify to a board of experts that the increase is reasonable. While this might not keep premiums from rises, it will definitely prevent huge increases.

It’s a close call. The Congressional Budget Office estimates that with health reform, the average annual premium for an individual plan will be about $5,800 in 2016. Without the reform bill, it would be closer to $5,500.

It’s hard to say whether you’ll come out ahead on your premiums after health reform goes into full effect. But coming out ahead as far as good reliable coverage? That’s more certain.

Has your health insurance premium increased lately? Tell us about it.

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Insurance Companies Are Courting You

Have you noticed your health insurance company getting a little warmer and friendlier lately?

A trend of insurers “putting customers first” has definitely begun. Whether it will translate to real savings for consumers is the question.

In a great, recent blog in the New York Times, author Tanzina Vega talks about how insurers have been ramping up their PR campaigns, trying to combat the reputation the industry has picked up for bad service over the years. Now, many of the largest companies are trying to put more of a focus on their customers, in a variety of forms: discounts and rewards for losing weight or quitting smoking, consumer-friendly cost comparison tools, or just slick campaigns branding themselves as not just insurance, but family friendly health care solutions.

So this got us thinking. How do health insurers rank when it comes to customer satisfaction? Are they really that bad? Are they getting better?

We looked up ratings from the American Customer Satisfaction Index—a national scoring of major service sectors (ranging from 0 to 100). Turns out Americans’ opinion of health insurance companies has generally been getting better over the last 10 years. Though they are still near the bottom of the pack with an average score of 71: just a bit worse than the US Postal Service, which averaged 73, but still lagging far behind internet retail, at 81. However, most of us think calling our health plan is better than calling the airline we’re flying.
To compare other industries, visit http://www.theacsi.org/

Why the big push to please consumers now?

Much of it relates to the health reform bill, which is expected to make almost 20 million Americans newly eligible for private insurance coverage. So what better way to start competing for new customers?

So we might expect the score for health insurance companies to continue to rise, but is customer satisfaction the same as good health care coverage? Or could it be a distraction from increasing out-of-pocket costs? Reward programs are nice but when it comes down to needing a surgery covered, they’re no substitute.

We have yet to see, but one thing seems promising: insurance companies are paying more attention to you than ever before.

Tell us what your health plan has done for you that you love, and how you’d rank them on the Customer Satisfaction Survey.

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