Ask Hari

Answer:

Unfortunately, it is legal. The HIPAA law does designate the facility to charge within reason. Most institutions allow for a small number of pages to be free. Make sure you request specific documents like radiology or a specific specialist. Otherwise, the cost will be high.

Answer:

I would tell the doctor that because the bill wasn't submitted in a timely fashion to the insurer, then it is his/her responsibility. By not submitting the bill to the insurer, you were denied the right of appeal if required. All medical practices know the time limit on most insurance is 12-18 months for reimbursement. If they insist you pay, contact the state Attorney General's office and file a complaint.

Answer:

According to the Maryland Health Commission, there is no requirement for providing full time employees insurance. However, after 2014, it is mandatory or the business will have to pay a penalty.

Answer:

Getting a second opinion on a biopsy is an excellent idea. First, you need to decide where you would like the second opinion from. You will need to contact the pathology department and find out their protocol for looking at pathology. Sometimes, a pathology department may request a doctor to be the referral source. Next, you will need to have the slides of the biopsy sent via overnight mail from the original department. Make sure you have the correct address and a contact person's name. Follow up the next day to verify the slides have been received. You may request a copy of the results be sent to you. Some institutions will only send a copy to the referring MD.

Answer:

The Health Care Proxy is a simple legal document that allows you to name someone you know and trust to make health care decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions. You may have more than one person, if you want. It can only be invoked, if a doctor decides you are unable to make decisions for yourself. If you do not have a Health Care Proxy, then the medical staff will make the decisions. The form needed to name a Health Care Proxy can be found in several places. Any lawyers office will have it. You can also go to your state's Department of Health website and find a form. Legalzoom .com also has forms available.

Answer:

Generally no. The exceptions are for some reconstructive surgeries. For instance, breast reconstruction from a mastectomy. Burns or animal bites will fall in this category Most plastic surgeries are considered elective and not medically necessary. Surgeries for cosmetic reasons are not reimbursed. Check with your insurance company before proceeding.

Answer:

First, I am sorry to hear this has happened to you. I would file an external appeal with the insurance company. An external appeal is reviewed by an outside organization. I would call your state department of insurance and file a complaint. Next, the new health reform act mandates each state to have a risk pool that will cover you with any pre existing conditions. However, you need to have been without insurance for six months. States also have a separate high risk pool with no time limit for preexisting conditions. This high risk pool often has higher premiums. Check on your state's Department of Insurance or Department of Health website. Every state website is www.initials of your state.gov Contact your state and federal representatives and let them know what has happened to you!

Answer:

If you have concerns about a new medication, here are some things you can do to get answers. Call the doctor's office who prescribed the medication and ask for clarification. You can ask to speak with a nurse. You can call your primary care office and ask the doctor or nurse to clarify. You can ask your pharmacist to do a review of your medications and if there are any interactions. You can go on line to sites like http://www.drugs.com/drug_interactions.php www.drugstore.com http://www.healthline.com/druginteractions

Answer:

Out of pocket limit is the top amount you pay from your pocket per year. Insurance policies designate the top limit. The insurance company decides what is included in the out of pocket limit. It may include deductible and coinsurance or it may designate the coinsurance only and the deductible separate. Copays are not included in the out of pocket limit. It is important when deciding on an insurance policy to know what the out of pocket limit is.

Answer:

Most doctors will support your right to get a second opinion. However, there has been occasions when doctors get annoyed at the idea. The reason for a second opinion is to learn if there are options. Doctors don't always agree on treatment and it is important to feel secure and knowledgeable on what treatment you will be receiving. I encourage everyone to always get a second opinion

Answer:

The medical power of attorney is a legal document that designates the person or persons who can make medical decisions if you are incapacitated. With this document, the hospital personnel has to get the approval for any procedures, surgeries, change in care, life saving measures and discharge plans from the designated person or persons. Without it, the hospital legally has the right to make final decisions.