#89 - Health Insurance 101 for Doctors: Navigating Claims and Coverage

Are you frustrated by the health insurance approval process for medication?

Many patients may not know what their doctors are doing behind the scenes when dealing with health insurance, and many doctors may feel overwhelmed by this process. There is a silver lining! Tools exist to help patients and providers better navigate the complexities of health insurance.

Elizabeth Johnson joins Dr. G and Kortney to share her expertise on overcoming the hurdles of securing medication approvals. She explains the biggest challenges healthcare providers face when working with insurance companies. She offers practical tips to navigate the approval process more efficiently.

Together with Dr. G, they discuss the lack of health insurance education for providers and the burden this places on medical staff. They also explore available resources and tools for healthcare professionals and stress the importance of incorporating insurance education early in medical training.

What we cover in our episode about health insurance from the provider’s side:

• Provider Challenges: Elizabeth explains the common hurdles doctors face in securing medication approvals, from paperwork to insurance denials.
• Navigating Insurance Companies: We explore the complexities of insurance approvals, from prior authorizations to the importance of good note-taking.
• NAMAPA Toolkit: Elizabeth introduces the NAMAPA toolkit, designed to assist healthcare providers in navigating all aspects of health insurance.
• Insurance Education: We highlight the need for insurance education during med school, residency and fellowship.
• Health Insurance Resources: Elizabeth shares strategies to ensure healthcare professionals have the tools to handle medication approvals and the resources available from pharmaceutical companies.

More resources:

• Medication Access Coordinator Training From NAMAPA
• Health Insurance Coverage in the United States
• Why was my prescription denied by insurance?
• Health Insurance for Asthma and Allergies
• Choosing the Right Health Insurance Plan
• Navigating Insurance Denials and Filing Appeals
• NAMAPA: National Association for Medication Access and Patient Advocacy
• Medication Access Network
• MedicoCX