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When we are about to have surgery at a hospital or outpatient surgical center, we usually check for network status of the facility and surgeon, to be sure we are getting the best benefit for that service.  As we know, staying within the network of our plan will result in lower cost sharing for us. … Continued

One of the easiest and most efficient ways of tracking your insurance claims and other activity is by setting up an online account. Most, if not all, insurance carriers, now have an online portal available.  This gives members the ability to perform many simple tasks, such as viewing and tracking claims, downloading  forms, looking up … Continued

As Employee Advocate here at Acadia Benefits, I spend a good deal of time helping our customers understand their bills from providers.  It is often confusing and hard to understand these statements.  The first thing we look for on a bill is some sort of reference to a payment or reduction from the insurance company.  … Continued

I have been very busy this summer working on our customers’ disability claims! One recurring issue I have come across is obtaining medical records for the insurance companies’ review. Most large medical practices now “outsource” their medical records distribution to a third party.  These third parties usually want payment for their time and resources.  The … Continued

As the Employee Advocate here at Acadia Benefits, I get several calls each month from our customers who are unsure of how a claim for “routine lab work” was processed.  Because their doctor ordered this lab work as part of their routine physical, many people assume the lab work will be covered in full, similar … Continued

Over the years, patients on HMO plans have learned the importance of obtaining referrals. What we need to remember, however, is that referrals are often written for a certain number of visits, or for a specific time frame. For example, a PCP may write a referral for a patient for three visits to an orthopedic … Continued

As we head into a new benefit year for many of our customers, it may be a good time to remind people about the importance of using the correct ID card during the transition time. There are occasions where the new ID card may not have been received by a member. In addition, their “old” … Continued

As benefits advisors, we are always looking for ways to find the best benefits for our customers.   Consequently, we may offer new and innovative ways for employers to cut costs, while still offering plans with viable coverage. One of those changes may be seen in vision plans. In the past, several carriers would offer routine … Continued