March 20, 2023

Why Insurance Plans Don’t Always Pay

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Imagine you go to the doctor for a check-up and are diagnosed with a serious illness! You’re relieved when you find out that your insurance will cover the cost of treatment. However, you soon learn that your insurance plan doesn’t always pay. How could this be? 

These are three of the biggest reasons why insurance plans sometimes don’t pay and what you can do about it.

Treatment is Out of the Network

Not all financial protection plans provide reliable coverage to pay medical bills. In some cases, insurance companies may deny benefits because the treatment services requested are out-of-network, meaning that you were treated by a healthcare provider not covered in your particular plan. 

This can be frustrating for those needing care and cause them to question why their insurance does not reimburse for certain treatments. However, there are cases where certain out-of-network services may be covered under unique circumstances, so it is important to investigate those possibilities when searching for financial means to cover the cost of needed treatments.

The Treatment Isn’t Medically Necessary

Insurance plans are designed to cover medically-necessary procedures, to protect individuals from unexpected medical costs. It’s not uncommon for insurance providers to deny payment when the procedure being requested isn’t considered a medical necessity. 

Many dental plans won’t pay for treatment unless it’s medically necessary. Unfortunately, this can often lead to large out-of-pocket expenses, especially when the treatment could potentially provide valuable benefits such as improved oral health or an enhanced appearance. It is thus essential that consumers thoroughly review their coverage options before pursuing any treatments or procedures not classified as medically necessary.

You Have a Deductible

Understanding our insurance plans can often be complex, and one area of confusion is why claims may not get paid in full. While there are a variety of reasons why this might happen, one common cause is that you may have a deductible to meet before certain services are covered by your plan. A deductible is an amount of money you must pay out-of-pocket before your insurance will pay for some or all of the remaining costs. The amount of your deductible depends on your specific plan, though it’s important to remember that meeting it could save you significantly more than you would otherwise pay in total for the service. Educating yourself about how deductibles work can help you make smarter healthcare decisions in the future.

Insurance is necessary to keep you and your family protected. But that being said, insurance won’t always foot the bill when you need medical care. Understand these reasons why insurance plans may not pay and how you can better ensure your insurance will cover your care.

Did you enjoy reading this article? Here’s more to read. How to Protect Your Business From Liability

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The Largest Costs Long-Term Care Facilities Face

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Long-term care for seniors and the critically and chronically ill is a vital service that helps to improve the health and quality of life for people who require care day-to-day. If you are thinking about opening your own long-term care facility, or operating a long-term care facility, then you also understand that there are major costs associated with running and operating a long-term care facility. Long-term care facilities can still be a financially viable business, however, if you know what expenses to expect and how to manage the large costs. Here are three of the largest costs long-term care facilities face.

Staffing

The first and typically largest cost that long-term facilities face is the costs of staffing the long-term care facility. To run a successful long-term care facility, you are going to need a lot of staff with varying qualifications and skill sets. You are going to need registered nurses and doctors to take care of patients, as most everyone in the facility will require daily medical attention. You also need kitchen staff to prepare meals for the residents and staff to run enrichment programs and ensure a high quality of life for all residents. Be prepared to pay for quality employees.

Prescription Drug Expenses

Another major cost that long-term care facilities face is the cost of prescription drugs for patients. Long term care facilities often can get prescription drugs sourced from special long-term care pharmacies, which are often owned or operated by the long-term care facility as well. But if you live in the United States, you know that drug prices are outrageous. When it comes to drug prices, price fluctuations present a challenge for facilities. Bulk contracts that involve major supply deals are a great way to get the best price possible on your prescription drug needs in the face of changing supply and demand.

Rent/Building Costs

The final large cost that long-term care facilities face is the cost of rent or building costs. Rent is always expensive, regardless of what kind of property you are trying to rent. Owning buildings and property is expensive as well, with interest rates set to continue to skyrocket this year. The largest fixed cost that operating a long-term care facility carries with it is the cost of rent. A good way to save on this is to own the building yourself. While you will have a mortgage to pay, you are building ownership of the asset which is essential for growing your asset pool.

Running a long-term care facility is far more expensive than many people realize. If you operate or want to operate a long-term care facility, you need to understand the associated costs. Learn about these three most common large costs that long-term care facilities face so that you are prepared.

Check out this article on how to reduce your taxes as a small business!

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The Recent Rise of Sleeping Technology

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Sleep is extremely important, but let’s face it, the majority of us don’t get nearly enough sleep that we need. Everyone has such a busy life. With jobs, children, exercise, and social lives sleep often tends to take a little bit of a back seat. Plus, with all of that going around in your mind, when it comes to actually putting your head down, your mind is so full of thoughts that you can’t get to sleep anyway!

Although there are many ways in which we can improve our sleeping pattern, some people are turning towards smart sleep technology to help them out. Much of this technology is geared towards tracking sleeping patterns and the quality of the slumber. Although this does not directly help you to sleep, often people don’t realize just how little sleep they are getting until it is in front of them. This could be the push that is needed to encourage people to go to bed a little bit earlier.

Another direction that people are turning to are mattresses. The quality and type of your mattress can have a huge impact on the quality of your sleep, and which type is best depends very much on the individual. Today, a mattress can offer a lot more than support, they can also be full of tech. If your mattress is old and causing you discomfort, consider looking through some mattress offers to see if you can find something better.

Adjusting Mattresses

If you have trouble getting into a comfortable position when in bed, then the adjustable mattress may be for you. Often you will also have to purchase an adjustable base in addition to the mattress so that you can get into the optimum position for sleep. These types of bed come with a remote control that allows you to move either the head or the foot of the bed accordingly.
Some models even come with a massage function where you can pinpoint where you want to target, be it just your head, your feet, or your full body.

Smart Mattresses

This is the term used to describe any type of mattress that is built with sensor technology. They are used to monitor the sleep patterns of their owners and can track various elements such as how long a person sleeps, any restless sleep, body temperature, heart rate, breathing, and many other factors. Although this type of tracking is the main function of a smart mattress, some may come with other, additional tech features such as built-in alarms or even internet connectivity!
With the growing use of mobile phones and apps, a lot of smart mattresses can utilize app technology, so that you can adjust them using your mobile device.

Temperature Regulation

Although not necessarily tech-related, a temperature regulating mattress is a nice addition to the market. If you find yourself too hot or too cold at night, this mattress can be the answer. Filled with tiny gel beads, they have the power to draw heat away from your body when it is warm, storing it, and then releasing it back up to you when it gets colder.

Smart Beds

Slightly different from the smart mattress, the smart bed can sense your position, whether you are on your back, front or side, and makes automatic, real-time adjustments to help you sleep at your best. It can become firmer or softer in an instant, providing you with support when and where you need it. It also has the power to provide sleep data every morning so you know just how well you did or didn’t sleep.

This type of mattresses provide the benefits of a range of wearable technology without you having to change lifestyle or normal habits. You don’t have to remember to turn any device on when it is time for bed.

We are living through the rise of sleep technology, and in addition to mattresses, there is a huge range of other gadgets and devices that have been created with the aim of helping you to sleep. Smart pyjamas, for example, is a more recent invention, one that doesn’t seem to have quite hit it off just yet. These pyjamas have been made using bioceramic imprinted fabric that cools off the body’s infrared head emissions with the goal of giving a longer and a deeper sleep.

Another technology that is meant to improve your sleep is the breathing tracker. The device comes in the form of a chest strap and an app, matching your breathing to tonal music that gradually starts to slow down. Subconsciously your breathing will start to mimic the beat of the music, prolonging exhalation. The aim here is to ultimately help you get to sleep quicker than you originally would.

Smart pillows are similar to smart mattresses in the sense that they track your sleeping throughout the night. They are connected to an app that factors in the quality of the previous night’s sleep and then offers personalized sleeping tips throughout the day to help you the following night.

There is a huge range of sleeping tech out there, and if things continue how they currently are, it is likely that much more will be developed in the near future. Be sure to look out for deals and discounts in this industry. Considering it is a fairly new technology, some of them start with quite a hefty price tag. Is 2018 the year of smart sleeping? Only time will tell.

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Developing an Elevator Pitch – First Impressions Matter

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Elevator-PitchIn simple words, an elevator pitch is a brief presentation that’s designed to grab the attention of potential prospects in a compelling and comprehensive manner.

So, if you had one minute with Oprah or someone you admire in your industry, what would you say to capture their attention?

Criteria for a successful elevator pitch:

It must be Quick, Clear, and Concise! Attention grabber is important too.

Be clear; use a proper speed & tone so that you avoid rushing your message.

Show your enthusiasm using appropriate excitement while telling the story. Enthusiasm plays a key role if you want to draw the attention of your target audience.

 

Does your elevator pitch answer the following questions…..

Who are you?

What do you do?

Who is your target audience?

What separates you from other businesses in your industry?

How do you bring value and benefits to your prospects?

 

Get a note card and have a 30-sec and 60-sec elevator pitch ready. Then start to practice and test to see what sticks. This is one area I love helping my clients shine!!!

 

Share your elevator pitch with us!

What I am looking for next is……

 

To your business & life success,

Shannon Gronich

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Breast Health – What’s your story?

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Working on a book and multi-media project to help prevent and even reverse breast cancer naturally. We have celebrity participants and marketing team to take the book to an Amazon Best Seller!! What we need next…..
We are looking for individuals that have utilized complimentary medicine or non-invasive treatments that have help them reverse cancer of any sort (especially breast). We want to share your story!!!

AND

We are seeking a handful of women looking to prevent or conquer breast cancer to join a pilot 8 week “Breast Health Support Group”. Applicants accepted will be implementing what doctors and other experts are sharing from the project, while being filmed and/or journaling their journey. No Cost!!!

Please share with us your story!
Office: 321-549-2128
www.ConsciousLivingPublishing.com
info@ConsciousLivingPublishing.com

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