Search

Things to Look Out for When Going To a Medical Provider

Updated: Sep 18, 2020




Hello! Welcome Back to another post! If you haven't already done so please check out some of my other posts on my website on www.ascentptny.com. This topic is something that can branch off into many topics but I want you to understand at least the basics today of what you should be looking out for when going to a provider. This goes from what you get from the first time you call, to how your insurance works for/against you, and even your visit itself with the doctor/professional. Make sure you are getting what is BEST for your health....NOT what is the best thing you can get from what you insurance can provide. Each of these topics have everything to do with experiences I have personally witnessed with other patients and even patients I had while working in a high volume Physical Therapy clinic. Let's find out what I have to talk about below.


  1. BEFORE Even Going To The Doctor/Medical Professional Make Sure You Understand Your Insurance You have no idea how many times I come across or overhear patients checking out and they get the cost of their visit outside of their copay and they go, "I didn't know I had XXXX. " The XXXX can be mean a bunch of things that are included in your insurance that are in addition to your monthly premium and your copay. This can include a:

  2. Co-insurance - a percentage of payment you make for your health care needs in addition to your premium while the insurance pays the rest - this can be as high as 50% of the total cost of a visit!!

  3. Deductible - a certain amount of money you have to pay BEFORE the insurance pays ANYTHING in ADDITION to your monthly premium - this can be at times 10's of thousands of dollars, BEFORE the insurance pays ANYTHING

  4. Non-covered Service - some services are not covered by your insurance but while it may say that a certain type of provider is covered such as your Yearly exam by your primary care provider, the EKG they suggest to have may not be. These are all things you need to make sure you both understand and know BEFORE even choosing your insurance plan, whether you are getting health insurance from your employer or you are getting it from your state's health insurance marketplace. By reading ALL OF THE FINE PRINT, you will avoid any additional heart ache and surprises at checkout after receiving a health care service.

  5. When Calling To Schedule An Appointment, Make Sure You Are Treated With Respect AND Have All Of Your Questions And Expectations Met Prior to Coming In The Office Not only do I have this happen to myself but I have heard way too many patients and friends get surprised when they go to a provider and it was no where near what they expected. So many of us health care consumers assume that each and every health care provider is there to provide them with the highest level of care. With this topic I do not wish to scare you but rather enlighten you to the realities that do occur at times. If you go to a surgeon you are more likely going to get prescribed injections or surgery. If you go to a physiatrist you will more likely be prescribed injections, pain meds, or sometimes Physical Therapy. If you go to your Primary Care MD, you are more than likely going to be asked regularly if you want your flu shot. Medical providers for the most part DO care about your health and do hold what's best for you first and foremost. However, there are some that will revert back to what they know best and what they make the most money for both the practice and then themselves. (A surgeon does not make money if he does not perform surgeries...that's the simple fact of it.) Anyway...Back to the topic. When you call to a provider, if you get the person that picks up the phone and already sounds like they DO NOT want to speak with you and feel like they will not set you up for success...HANG UP AND RUN AWAY. Every step of an experience with a health care provider should provide you with the support, encouragement, satisfaction that you are receiving the best experience. If you have something going on and you are scared about what it is, would you feel more comfortable with someone who is gruff on the phone and not interested...or someone who shows genuine concern for your needs???....think about it...the answer shouldn't be too hard. If the medical provider is THE BEST but his support staff doesn't set himself/herself up for a superior experience on your end, then that employee should be let go. Just a thought. You deserve the respect and understanding that you and your health are going to be the forefront of what is going to be cared for when you head to the office. Don't let your experience come second. You and your health are the most important!!

  6. When Going To The Doctor/Medical Professional...Make Sure They Look You In the Eye... If you have ever been to a medical professional and they spent their entire time looking at the computer screen writing their note and then when they go to take a look at how things were doing and still don't look you in the eye....I AM SOOOO SORRY. This should never happen to you when you are seeking medical care. In a situation where sometimes you are scared, unsure, not confident about what is going on and the person in front of you does not even take a second to acknowledge that you are a PERSON, you deserve someone much better. If you have ever experienced this type of practitioner or go to someone after reading this and experience this...find someone else. It is not worth your time because their best interest is not you. Whatever they are looking at or doing is. YOU come SECOND. A practitioner that deserves to have you as a patient is someone who looks you in the eye, answers your questions, listens to your concerns, settles your fears. They should then give you the best options that will help assist you in the purpose of the visit, not the one that pays them the most. They should give you the outcome you desire in the best way that is feasibly possible and tell you the reasons why you should choose the one that is best for you.

These are just three things you should be looking out for when going to see the MD but there are other factors at play that you should pay attention to. Some other factors you should pay attention to include ensuring you understand your explanation of benefits when working with the provider to ensure that you know what is and what is not covered and be provided with additional education you can go home and research on your own before making the appropriate decision about your health (especially if you are getting surgery).


If you have been looking for a Orthopedic Physical Therapist or health care provider that will assist you appropriately in the ways that you deserve, please head over to www.ascentptny.com or call 516-387-4669 to find out if I am the best to assist you. If I am not the best person to assist you with your needs, I have a network of other wonderful providers that I can help set you up with.


I hope you found this blog post very beneficial and informative. If you have any further questions please feel free to reach out at rberghorn@ascentphysicaltherpyny.com



10 views0 comments

Dr. Robert Berghorn, Jr.

rberghorn@ascentphysicaltherapyny.com

516-3TRINOW (516-387-4669)

Fax: 516-321-0721

©2019 by Ascent Physical Therapy, PLLC. Proudly created with Wix.com