Episode 17: Understanding and Navigating the Health Insurance System


Episode Summary:

Every person in the US needs the information in this episode. First, to learn how to make informed and efficient health care decisions for themselves in our current insurance system. And second, to gain an understanding of how the current system works and doesn’t work, so they can evaluate the different positions on fixing the system taken by various political and organizational platforms. 

Episode Guests:

Dr. Jeffrey Frankel M.D.  Urologist with Frankel, Reed, and Evans; President of the Western Section of the American Urological Association.

Mark Painter, B.A. Vice President of Coding and Reimbursement Information for Physician Reimbursement Systems, Inc. (PRS). Managing Partner of PRS Consulting, LLC; CEO of PRS, LLC.

During This Episode We Discuss:

  • What your medical coverage does and does not cover. 
  • How medical billing works.
  • Is the price on your hospital invoice really the price?
  • How medical pricing is done. Fees are set by Medicare.
  • Narrow networks and co-payments, are you really covered?
  • Medicare coverage and payments.
  • Fail First Therapy….why can’t you take the medication your physician prescribed?
  • How to select an insurance product that’s best for you.

Quotes (Tweetables):

“ Patients think that they have the same insurance, or on a yearly basis they get offered new plans with lesser premiums, they sign up for those plans for economic reasons and then subsequently find out they can no longer see the same doctor….it’s unfortunate but common.”

 Jeff Frankel, M.D.

“Medicare rates for physicians have been flat, or haven’t gone up for about 10 years”

We’re providing more care to more people, we are using more resources on fewer people that are living longer and using more care, we are using more technology, more medications…those shifts are really taxing everyone in the marketplace.”

 Mark Painter

Recommended Resources:

Episode Transcript: 

Coming soon!!

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