This is never fun for anyone but it can be especially difficult for medically complex children. Instead of a doctor’s office or two, there’s a medical supply company, the pediatrician, and all of their specialists. Prior authorizations have to be submitted to the correct insurance, so you may need to update insurance information with doctors you haven’t even seen yet!
Tip #1 – Call the new insurance company. They won’t be able to tell you much until the insurance activates, however, you can request a case manager be assigned before the transition. This gives you an advocate on the inside that already knows your situation before the paperwork starts flowing.
Tip #2 – Call and update insurance info with all of the doctors who write a perscription for your child. That way if there are any issues at the pharmacy which require additional paperwork from the doctor’s office the responses get sent to the correct location.
Tip #3 – Let the medical supply company know in advance. They can prevent unnecessary out of pocket costs by verifying coverage prior to sending out your supplies. If something isn’t covered you can order less of it if you have a oversupply.
Tip #4 – Expect hiccups in January. Most doctors offices require you to sign off that your insurance information is up to date and accurate prior to being seen but not all. It’ll be easier on both sides if you can keep a list of which you’ve updated and which you haven’t. Also, make sure they know the effective date if you tell them beforehand. That way they don’t bill to the wrong insurance company. If, like us, you’re switching Jan 1st they should be able to figure it out. It’s a popular day for the transition.
Tip #5 – Don’t forget the pharmacy. They need the new insurance information to prevent a delay in filling perscriptions. They’ll be the first to find out if something needs prior authorization or if a medication you were taking isn’t covered by the new insurance company.
Taking care of these five things won’t prevent all of your headaches in January, but it will certainly reduce the number by a significant amount. Enjoy your new years!