Medical Billing Advocacy Topic Discussed
Reducing Medical Bills 00:32
The interview focuses on ways to reduce medical bills, as discussed in Adria Gross’s book. Edison Guzman introduces the topic, emphasizing its relevance given the new administration and potential changes in healthcare policies. Adria Gross, as an expert in medical insurance advocacy, shares her insights on various strategies to lower medical expenses.
Medical Tests and Their Necessity 01:18
Adria Gross discusses the importance of questioning the necessity of medical tests. She explains that doctors may sometimes order excessive tests for various reasons, including self-protection or financial incentives. Gross advises patients to:
– Ask doctors about the necessity of each test 01:57
– Consider getting a second opinion 01:32
– Be aware that some doctors may have financial interests in testing facilities 02:15
– Question routine procedures like chest X-rays during hospital visits 02:32
The discussion emphasizes the importance of patient advocacy and informed decision-making in healthcare.
Insurance Coverage for Medical Tests 03:57
The conversation shifts to insurance coverage for medical tests. Key points include:
– The possibility of insurance companies declining coverage for unnecessary tests 03:57
– The importance of contacting insurance companies before undergoing tests 04:06
– Recommendation to record conversations or get written confirmation of coverage 04:18
– The complexity of pre-authorizations and potential future denials 05:01
Gross shares personal experiences of successfully lowering medical bills by questioning charges 05:36.
Medical Tourism 05:56
The interview covers the topic of medical tourism, highlighting both its potential benefits and significant risks:
– Definition: Seeking medical procedures abroad for cost savings 05:59
– Common procedures: Dental work and plastic surgery 06:37, 06:45
– Major risk: Lack of insurance coverage for complications upon return to the US 06:15
– Advice: Carefully consider the risks before pursuing medical tourism 07:12
The discussion emphasizes the importance of weighing potential savings against the risk of uncovered complications.