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When a health insurance renewal comes back with a rate increase, a business owner’s first reaction is usually to call their broker and ask, “Can you send us a few quotes?” It’s a completely fair request—they want to see what other insurance carriers can offer to keep costs down. However, because most traditional brokers go…
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When an employee walks into HR holding a new medical bill and asking, “I already met my deductible—why am I still getting bills?” it reflects a very common misunderstanding. Most employees reasonably assume that once they pay their deductible amount out-of-pocket, the insurance carrier takes over 100% of costs from there. However, for most modern…
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When you’re injured or in pain, asking an intake desk “Do you take my insurance?” feels like the natural first step. But that simple question doesn’t always yield the answer you actually need. While on a recent vacation hiking in rural western New York, I took a hard fall on a wet trail and severely…
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When an employee schedules their yearly wellness visit, they expect it to be covered 100% as preventive care under their health plan. However, a routine appointment can quickly turn into an unexpected bill over simple conversation. During the checkup, an employee might casually ask about a sore knee, recent headaches, or a minor rash—and that…
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When an employee comes to HR distressed saying, “But the hospital was in-network,” it usually follows an unexpected, costly medical bill. To the employee, a surgical procedure is a single event at an approved facility. To the healthcare billing system, however, that same procedure is divided into multiple independent transactions—meaning an in-network hospital can still…
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When an employee walks into HR frustrated saying, “My insurance denied my MRI,” it immediately creates tension across the team. The employee feels let down by their coverage, HR is forced to scramble for answers, and blame is quickly pointed at the insurance carrier. However, when you dig deeper into these situations, you often find…
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A few days ago, I received a call from an employee at one of my client’s companies. She sounded frustrated. “Al, my doctor’s office told me they accepted our insurance… so why did I get this bill?” It turned out she’d done exactly what most people would do. Before scheduling her appointment, she called the…
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A business owner said something to me recently that I’ve heard more times than I can count. He leaned back in his chair, crossed his arms, and said: “We should be okay. I think payroll handles all of that.” I didn’t answer right away. It wasn’t the word “payroll” that caught my attention. It was…
