Offering Insurance Experience

Greetings to everyone! I am on my way to a positive and healthy lifestyle by way of this surgery. I have already been approved by my health insurance/medical group, so now we are walking through the process of galvanizing me for the surgery. My medical group/insurance company, Kaiser Permanente, has come a long way and is very proactive in providing ample education to ensure that all patients who are approved are making the right decision. After all, this decision is a life changing one. In any fashion, the point of this post is to offer my insurance experience. I have many years of working as an employee in various insurance companies, so I am aware of the concepts of pre-certifications, appeals, complaints, grievances, benefit plans and structures, etc. Please be aware that there are hundreds, possibly thousands, of different insurance plans that a person may elect. I will not be familiar with them all, but they all work under the same generalized rules: HMOs are guided by capitation agreements; PPOs and EPOs are guided by contracted rates and usual and customary charges (U&C). So, feel free to e-mail me at [email protected] if you have any questions or need someone to help you understand your benefits and how they might apply to you. Thank you for taking the time to read this posting.

I think think it is very kind of you to offer free advise to the many people here on OH!! God bless you and your generousity!! Jl