Plagued with chronic sinus issues, Rita listened with interest to the drum beat of ads from a local ENT Clinic. After a consultation and in office CT scan, a surgical procedure was scheduled for late this month.

The Clinic is in Rita’s health plan network, but they asked for cash up front.

Huh?

Employed by a good client, she remembered her agent wants to know about ‘stuff’ like this. Before the horse is out of the barn.

We asked her Insurer A what she should do. The reply: “That is really between the member and provider to determine if they will pay anything prior to the services being rendered.”

Same question to a different Insurer B with this result: “Our contracts prohibit this practice; our Network Management Team will be reaching out to the provider to address this issue.”

Not coincidentally, Rita’s employer is switching to Insurer B this fall.

I’ve made this point before but it bears repeating.

When evaluating which health insurer is best for your employees, look beyond the premium spreadsheet!