Tips to Choosing Your Healthcare Plan Wisely

What to Ask When Choosing Your Healthcare Plan

The 2019 open enrollment period opened on November 1st and ends on December 15th, 2018, this means that many of us are actively shopping for the health care plan that bests suits our needs and budget.

To get the most out of our medical insurance plans, we must understand how the plans work, and what they cover. State and Federal insurance laws obligate insurers to include certain benefits and provide certain protections; however, insurers offer different plans from which you can choose, some will provide more coverage and protection than others, but this usually means the extra coverage comes at a price.

When you are shopping for healthcare coverage, insurance companies will provide a summary of each of their plans, this information will help you choose the right plan for you and your family. But, keep in mind the insurers won’t provide all the details of the plan until you have enrolled in the plan.

healthcare-plan

What is a Healthcare Policy?

For all intent and purposes, a health care policy is a legal contract between you and the health insurance company or health maintenance organization (HMO). When you enroll in a program, the insurance company or HMO will provide a copy of the contract, this will give detailed information about what your rights and responsibilities are under the plan.

For more information on the types of plans offered in Texas, please visit the Texas Department of Insurance (TDI)

healthcare insurance

Can I Cancel the Plan If I am Not Satisfied with the Coverage?

Yes, when you receive your copy of the policy detailing all the benefits, it is essential you read it carefully, especially if you have any special health needs. This will be the first time you are seeing the details of the coverage you will receive, and it’s important for you to know that if you are not satisfied with the policy, you have 10 days to return it and get a refund of your premium.

What is the Best Way to Compare Plans?

When you are shopping for medical insurance, ask the provider for their summary of benefits and coverage. This is the best way for you to compare healthcare plans as this document uses a standardized format making it easier to compare one item to another.

This summary outlines the basic coverage and cost of the plan you are interested in and will include the following:

  • Benefits and Exclusions
  • Links to Your Preferred Provider Directory and Drug Formulary
  • Deductible Amount
  • Coinsurance and Copayment Amounts
  • Out-of-Pocket limits
  • Referral Requirements
Medical-plan-patient

Always Ask About Emergency Medical Coverage

State and Federal laws obligate insurance companies to include Emergency Medical coverage in their policies. However, as we mentioned before, how much is covered can change from one plan to the next. As of August 6th, 2018, the Texas Department of Insurance (TDI) approved a controversial new program which grants the largest Health Insurance company in Texas to deny payments for some ER visits. Therefore, it is crucial to ask how your plan will process emergency medical treatment and ER visits before you enroll.

Can You Appeal a Deny of Payment on ER Treatments?

Absolutely, every consumer has the right to appeal the insurance company’s decision to not pay for treatment received in the ER.

According to the TDI, they received assurances from the insurance company that patients will have the right to have their doctor debate the treatment plan provided with the insurer doctor before a denial of payment was issued, and patients will be able to appeal the denial with an independent review organization.

Altus Emergency Center’s Patient Advocate department is available to patients review their health insurance claims and to aid in the event of an appeal of payment denial. Our priority is and always been the wellbeing of our patients, and our doctors follow care protocols to ensure the best medical care is provided.

Healthcare-claim

Know Where to Go In the Event of an Emergency

If you are ever in need of quality emergency care, you will not have to wait in line at Altus Emergency Centers. All of our ERs are fully equipped and open 24/7.

Altus Emergency Centers Texas is Here for You 24/7

altus emergency 24 hr ER Texas

Altus Emergency Centers are all open 24/7/365, with no lines. Our facilities are well-equipped to diagnose and treat everything from major to minor adult and pediatric emergencies.  We are honored to be a part of our beautiful Texas communities and work hard each day to help see them grow and prosper!

24 Hour ER Services – Best in Texas

Looking for the best quality 24 hour ER services?

We offer the best freestanding 24 hour ER services in Texas. We have top of the line medical technology and highly experienced ER healthcare experts prepped and ready to get you well fast in Baytown, Lake Jackson, Lumberton, and Waxahachie.

Each ER team is highly efficient in treating chest and abdominal pains, pediatric emergencies, flu symptoms, sports injuries, bone breaks, as well as all other major and minor injuries. All services are available 24/7, including weekends and holidays with little to no wait times.

Explanation of Benefits. What You Need to Know

Understanding the Explanation of Benefits

If you’ve been to the doctor or the ER recently and used your health insurance to help pay for the treatment, then you can expect to receive an Explanation of Benefits in the mail soon. But, what is this document, what should you do when you get it, and why is it important?

What do you need to know

What is an Explanation of Benefits?

Simply put, an Explanation of Benefits (EOB), is a notification to let you know when your health care benefits claim has been processed by your insurance company.

It’s important to understand that an explanation of benefits is not a health care bill. The EOB will detail the expenses that were submitted by the healthcare provider (doctor, hospital, ER, urgent care center, etc.) and lets you know how the claim was processed.

What do you need to know

What Information Does Your EOB Include?

There is no standard format for an explanation of benefits, however, most include three main sections:

  • Total of Claim or Claims: Your EOB might contain more than one claim. The notification will highlight all the financial information about each claim, including:
    • Total Amount Billed by the Healthcare Provider
    • Total Benefits Approved by the Insurance Company Based on Your Plan Coverage
    • Any Amount Owed to the Healthcare Provider
  • Service Detail: Here you will find a list of all the services you or your dependent received from the healthcare provider. This section should include:
    • The Name of the Doctor or Facility You Attended
    • Date of Services
    • Date of Charges – Both Billed and Allowed

Some Insurance Companies Display any Additional Savings that Your Plan Provides Such as Provider Discounts and Other Deductions

Summary: This Will Show You a Clear Picture of Your Deductible, Copays, And Health Spending Accounts if Applicable.

Additional information regarding amounts not covered, and out-of-pocket expenses might also be included.

What do you need to know

What Should You Do When You Receive an EOB?

Your explanation of benefits is an essential record of claims for any medical services and benefit coverage, and you should hold on to it for at least 18 months, preferably two years in case any questions or disputes arise from about your claim or your bill.

What do you need to know

What Do You Need to Check on Your Explanation of Benefits?

When you first receive your EOB, you should carefully check the information it contains, and pay close attention to the following:

  • Make sure your personal information is correct if not, it could be a simple mistake, but in the worst-case scenario it could be someone trying to use your identity
  • Ensure you are not being billed for a service you did not receive. If your EOB contains more than one claim, make sure you are not being charged twice for the same service.
  • Make sure which doctor or health care provider submitted the claim and cross check it with your records to make sure there are no mistakes.
What do you need to know

What Happens if the Insurance Company Doesn’t Pay the Whole Amount?

If your healthcare plan doesn’t cover the whole amount of the services you received, then the health care provider will send you a bill for the amount owed.

You do not have to pay anything until you receive the bill, and never pay more than the amount the explanation of benefits says you owe. If you are billed more than what the EOB says, you should contact your insurance company immediately, so they can investigate this matter.

If your insurance company didn’t pay anything, find out why, it could be that you have not met your annual deductible, but, it could also be a mistake on their part, if that is the case you need to submit an appeal.

 

Altus Emergency Centers has focused its efforts on helping people better understand their insurance plans and how our billing works. If you have any questions regarding your billing, please don’t hesitate to call our Patient Advocate Department, it will be our pleasure to assist you.

What do you need to know

Know Where to Go In the Event of an Emergency

If you are ever in need of quality emergency care, you will not have to wait in line at Altus Emergency Centers. All of our ERs are fully equipped and open 24/7.

Altus Emergency Centers Texas is Here for You 24/7

altus emergency 24 hr ER Texas

Altus Emergency Centers are all open 24/7/365, with no lines. Our facilities are well-equipped to diagnose and treat everything from major to minor adult and pediatric emergencies.  We are honored to be a part of our beautiful Texas communities and work hard each day to help see them grow and prosper!

24 Hour ER Services – Best in Texas

Looking for the best quality 24 hour ER services?

We offer the best freestanding 24 hour ER services in Texas. We have top of the line medical technology and highly experienced ER healthcare experts prepped and ready to come to your aid in Baytown, Lake Jackson, Lumberton, and Waxahachie.

Each ER team is highly efficient in treating chest and abdominal pains, pediatric emergencies, flu symptoms, sports injuries, bone breaks, as well as all other major and minor injuries. All services are available 24/7, including weekends and holidays with little to no wait times.

Preventing Accidental Injuries at Work and School

SAFETY STARTS WITH YOU!
Preventing Accidental Injuries at Work and School

At Altus Emergency Centers we’re the biggest fans of health and safey.  Today we’d like to show you a few easy pointers on preventing accidental injuries.

When it comes to improving safety measures in our daily lives, we can safely say, it’s a team effort. Every one of us can make small changes to our routines that will help make our workplace, schools, and communities safer.

We will start by looking at the most common preventable injuries, some tips to avoid them and what steps to take if they do happen.

Preventing accidental injuries at work

Preventable Injuries at Work

Repetitive Motion Injuries

Let’s begin preventing accidental injuries at work by learning about and how to avoid repetitive motion injuries.  Constantly making the same movements at our workplace, can create wear and tear on our muscles, tendons, and joints. Repetitive motion injuries don’t always require strenuous activity to develop; work activities such as typing and using the computer can slowly cause damage to our eyesight, increase the risk of developing carpal tunnel syndrome, and chronic back pain.

The pain you experience is due to damage to the muscles, tendons, and nerves, and can become irreversible if it continues for too long.

work-injury

How to Prevent Repetitive Motion Injuries

  • – If your job requires heavy lifting, follow proper lifting techniques such as:
  • – Lift heavy objects slowly and avoid jerky movements
  • – Face the item, do not twist your body when lifting
  • – Keep the object close to your body, your feet apart and lift with your legs, not your back
  • – Ask for help lifting items that might be too heavy to lift on your own
  • – Use ergonomic tools, like fatigue mats if you must stand for long periods, or adjustable chairs if you work at a desk.
  • – If you have a desk job make sure your workstation is adjusted to your needs, consider things like:
    • – Setting your chair where your back is straight and relaxed
    • – The top of your monitor should be at eye level to avoid having to bend your neck
    • – When typing your elbows should be at your sides, feet comfortably flat on the floor, and keep your wrists straight
Preventing accidental injuries at work

Slips, Falls, and “Walking Into” injuries

When we think of preventing accidental injuries the first thing that comes to mind is the typical slip and fall. Not paying attention where we are walking, as well as misplaced office furniture or equipment can cause a person to slip, fall, or walk into a static object resulting in head, knee, foot, back or neck injuries, depending on the speed and height at which the fall occurs the wounds could be severe.

How to Prevent Slips, Falls and Walking into Injuries

  • – Maintain a neat and tidy workplace
  • – Mark potential hazards/obstacles like glass doors, windows, and stairs so people can easily see them
  • – Place non-slip rugs in potentially slippery areas like entrances
  • – Use appropriate signs to indicate wet surfaces
  • – Cover and label uneven floor surfaces as well as cords on the floor
wet-floor-sign- prevention

Preventable Injuries at School

Schools are supposed to be these safe havens where we send our kids to learn all about all the wonders of this world; but, according to the Centers for Disease Control and Prevention, more than 9.2 million kids visit an emergency room every year for non-fatal unintentional injuries, and many of these occur in schools.  We hope that by focusing on preventing accidental injuries at school, we’ll have safer, happier kids.

The most common school injuries include:

Playground Injuries

While most of us can remember an instance where we suffered a minor injury on the playground when we were children, the reality is kids can be seriously injured while playing. Falling from monkey bars and swings, or tripping over equipment sends some 200,000 kids to an emergency room every year.

Preventing accidental injuries at school

Preventing Playground Injuries

  • – Demand that school playgrounds have soft materials covering the ground such as mulch, sand, or wood chips, this will help lessen the severity of the falls
  • – Kids need to be supervised by adults while on the playground, to ensure they only use equipment that is right for their age
  • – Playground equipment needs to regular maintenance, and guardrails installed to prevent falls
  • – Obstacles like tree stumps and roots should be cleared to avoid children tripping over them

Slipping, Tripping and Falling Injuries

  • – Aside from the embarrassment and bruised egos of kids, falling on stairs or wet surfaces can cause severe injuries like broken arms or legs, and concussions.

Preventing Playground Injuries

  • – Teach your kids never to run while going down the stairs
  • – Wet surfaces should be clearly labeled
  • – Place non-slip mats at all entrances and exits in the school
preventing playground injuries

Sport Injuries

Sports programs at school are essential for the development of kids. Sports help kids learn how to play as part of a team, embrace challenges, and push themselves to do more and better, but, safety must also be an integral part of every sports program.

Preventing Sports Injuries at School

  • – Kids should have access to proper fitting sports gear, helmets, shoulder pads, shin guards, and footwear
  • – Coaches need to teach proper techniques, and correct postures when necessary
  • – Keep kids hydrated
  • – Take breaks; even young bodies need to rest
preventing school sports injuries

What to do in the Event of an Unintentional Injury

We lead busy lives where we are often distracted by our phones or computers, and sometimes we are so used to our routines that we stop paying attention to our surroundings, this inevitably leads to unintentional injuries.

Depending on the severity of the injury immediate medical attention may be required, here is when you should come into the nearest Altus Emergency Center for treatment:

  • – If you sustained a head injury where you lost consciousness, or are feeling disoriented, tired, have nausea or trouble speaking
  • – Deep cuts where the bleeding does not stop
  • – Severe pain
  • – Severe swelling in the injured area
  • – You suspect you may have broken a bone
Preventing accidental injuries

Altus Emergency Centers cares about preventing accidental injuries.  However, should you or a loved one ever experience an injury, we are the best place have the latest diagnostic technologies and the most qualified emergency doctors and nurses to treat you and your loved ones; remember we are open 24/7 every day of the year.

Altus Emergency Centers Texas is Here for You 24/7

altus emergency 24 hr ER Texas

Altus Emergency Centers are all open 24/7/365, with no lines. Our facilities are well-equipped to diagnose and treat everything from major to minor adult and pediatric emergencies.  We are honored to be a part of our beautiful Texas communities and work hard each day to help see them grow and prosper!

24 Hour ER Services – Best in Texas

Looking for the best quality 24 hour ER services?

We offer the best freestanding 24 hour ER services in Texas. We have top of the line medical technology and highly experienced ER healthcare experts prepped and ready to come to your aid in Baytown, Lake Jackson, Lufkin, Lumberton, and Waxahachie.

Each ER team is highly efficient in treating chest and abdominal pains, pediatric emergencies, flu symptoms, sports injuries, bone breaks, as well as all other major and minor injuries. All services are available 24/7, including weekends and holidays with little to no wait times.

Summer Outdoor Safety – Tips to Enjoy the Great Outdoors!

Summer Outdoor Safety

Summer is finally here, if you needed an excuse to spend more time outdoors, then look no further, June is Great Outdoors Month and National Camping Month, imagine all the fun you can have during these long sunny days.

Camping is one of the best ways to enjoy nature; there is no better feeling than to sit around a campfire, telling stories, singing, roasting marshmallows, and sleeping under the stars with your favorite people, be it your family or a group of friends.

As fun as being outdoors is, spending too much time in the sun can carry serious consequences.  At Altus Emergency Centers, we have selected a few summer outdoor safety rules to help you enjoy the best of summer without regrets.

To avoid ruining your fun activities, follow our summer outdoor safety tips!

Summer outdoor Safety Altus Er

How to Stay Safe When Out Camping

To ensure your camping trip is a memorable experience for all the right reasons remember to:

  • Never build your campfire under low trees or branches, never leave a campfire unattended, and always put out the flame before going to bed.
  • Don’t approach wild animals, don’t try to feed them, and never disturb them while they are sleeping or eating. Stay away from mothers and their babies.
  • Keep your food in airtight containers, and your camp as clean as possible to avoid attracting wild animals.
  • Separate raw foods some cooked foods. Cook foods to proper temperatures and chill any leftovers promptly.
  • – Wear bug spray.
  • Watch out for poisonous plants; we recommend you do some research about the possible poisonous plants around your camping area, make sure everyone in your family knows how to recognize them.
  • Take a first aid kit that includes: band-aids and bandages, cotton swabs, sterile gauze pads, antibiotic cream, sunburn ointment, aspirin or ibuprofen, eye drops, thermometer, antibiotic soap, tweezers, small pair of scissors, heat, and cold packs, first aid manual, eye drops, as well as snake bite kit.
  • Keep a list of medications, allergies, and medical conditions for each person going on our camping trip. Make sure to include the contact information of their doctors and the nearest Altus Emergency Center.
Summer outdoor Safety Altus Er

Enjoy Your Water Activities to the Fullest

Whether you are planning to go fishing, boating, paddle boarding, tubing, water skiing, swimming, surfing, or kayaking, water safety measures should always be your priority.

  • Don’t go into the water alone, it is best to enjoy any water sport or activity with someone else, not only is it more fun, they can help you if you have an accident.
  • – Regardless of how good a swimmer you are, always wear a lifejacket while out at sea, lakes, or rivers.
  • Check the weather forecast before you venture out; paddlers should pay attention to wind and fog conditions near shore, surfers and swimmers need to be vigilant of rip currents. If you are going fishing or just taking a boat ride in open waters, you need to be cautious of strong winds, and rough seas as your boat could capsize.
  • Protect your skin, wear plenty of waterproof sunscreens, and reapply often.
  • – If you know you are going to be in cold waters, consider wearing a wetsuit. Water temperatures as warm as 75° – 80°F can pose a risk for hypothermia.
  • Label your gear with emergency contact information and any medical conditions or allergies you may have.
  • Always supervise children who are in or around bodies of water.
  • – Water sports and alcohol are not good partners. Stay hydrated by drinking plenty of water or sports drinks but avoid alcoholic beverages.
The long days of summer are meant to be enjoyed outdoors, plan your vacation with plenty of time, take as many precautions as you can and remember Altus Emergency Centers are always close by to help you in case of an accident.
Summer outdoor Safety Altus Er

Altus Emergency Centers Texas is Here for You 24/7

altus emergency 24 hr ER Texas

Altus Emergency Centers are all open 24/7/365, with no lines. Our facilities are well-equipped to diagnose and treat everything from major to minor adult and pediatric emergencies.  We are honored to be a part of our beautiful Texas communities and work hard each day to help see them grow and prosper!

24 Hour ER Services – Best in Texas

Looking for the best quality 24 hour ER services?

We offer the best freestanding 24 hour ER services in Texas. We have top of the line medical technology and highly experienced ER healthcare experts prepped and ready to come to your aid in Baytown, Lake Jackson, Lufkin, Lumberton, and Waxahachie.

Each ER team is highly efficient in treating chest and abdominal pains, pediatric emergencies, flu symptoms, sports injuries, bone breaks, as well as all other major and minor injuries. All services are available 24/7, including weekends and holidays with little to no wait times.

Men’s Health Month – Get Dad Healthy!

It’s Men’s Health Month!

4 Tips to Keep Dad Healthy

Men’s Health Month we celebrate men, so a big shout-out to all the dads, grandpas, hubbies, brothers, and father figures in our lives! Time to get dad healthy and keep him that way!

We all know this month we celebrate Father’s Day, but did you know that June is also Men’s Health Education and Awareness Month?  This is perfect timing to consider that the best father’s day gift is Good Health!

This observance is celebrated to raise men’s health awareness and encourage men of all ages to work together with their families to adopt a better lifestyle that includes exercise and healthy eating habits.

Mens-health-family

The most common diseases affect both men and women, however, according to the Centers for Disease Control and Prevention, women on average live five years more than men. While this is not great news for the guys, the male life expectancy gap improved from 1979 when women on average lived 7.8 years longer than men; however, male life expectancy has decreased in the last two years.

Men are now living longer in part because of the efforts to raise awareness about healthcare. Most men don’t like to talk about or acknowledge their health problems, this is mostly due to social stigma; sadly men have been made to feel ashamed for being ill, and it is because of this that most men don’t get regular checkups.

It is essential for both men and women to get regular checkups, as these aid in early detection of the leading causes of death in America, such as:

  • Heart Disease
  • Cancer
  • Chronic Lower Respiratory Diseases
  • Cerebrovascular Diseases (Stroke)
  • Diabetes
  • Kidney Disease
  • Influenza and Pneumonia
  • Chronic Liver Disease and Cirrhosis
  • Hypertension

Men’s Health has come a long way in the last 40 years, we have increased male life expectancy, and improved diagnostic tests, and treatments, but we can do more.

For this reason, the staff of Altus Emergency Centers wants to help dads live longer, healthier lives. We are already committed to saving the lives of those who visit our centers, but, as always prevention is the best medicine, so follow our helpful tips to improve your health and that of the extraordinary men in your life.

Mens-health-family

Protect Your Heart

Heart Disease is the number one reason men die in this country, luckily, there are simple ways to strengthen and improve your heart’s function, the most important one is diet.

Improving the way we eat, will help keep our hearts healthy, and you don’t need to give up all your favorite foods, but you should reduce the amount of saturated fat you consume, lower your sodium intake, and add more vegetables, and fruits to your diet. When serving, remember fruits and vegetables should be half of the plate.

You Got to Move it Move it

Most guys think exercise should be intense workouts with heavy weights. We won’t discourage this type of training, but, it is not necessary to be healthier. Just 30 minutes of moderately intense exercise a day is enough to help you live longer and improve your quality of life as you age.

altus-mens-health-work-it

Be Proactive

Think about how you take care of your car, you know preventive maintenance is essential, that is why you regularly change the oil, you change the brake pads, and rotate the tires, right? So why won’t you do the same for you? Don’t wait until you are feeling sick to visit your doctor, be proactive and take care of yourself; regular medical checkups can catch small problems before they become big ones.

altus-mens-health-doctor

Talk it Out

Life can be overwhelming sometimes, and just because you are a guy doesn’t mean you have to be tough and brave all the time. Emotional stress hurts our health and can take years off our lives; therefore, it’s not only ok to seek help, but it is also needed. So, talk to your partner, talk to a friend, or find a therapist who can help you deal with emotional issues.

Altus-mens-health-talk-it-out

Altus Emergency Centers Texas is Here for You 24/7

altus emergency 24 hr ER Texas

Altus Emergency Centers are all open 24/7/365, with no lines. Our facilities are well-equipped to diagnose and treat everything from major to minor adult and pediatric emergencies.  We are honored to be a part of our beautiful Texas communities and work hard each day to help see them grow and prosper!

24 Hour ER Services – Best in Texas

Looking for the best quality 24 hour ER services?

We offer the best freestanding 24 hour ER services in Texas. We have top of the line medical technology and highly experienced ER healthcare experts prepped and ready to come to your aid in Baytown, Lake Jackson, Lumberton, and Waxahachie.

Each ER team is highly efficient in treating chest and abdominal pains, pediatric emergencies, flu symptoms, sports injuries, bone breaks, as well as all other major and minor injuries. All services are available 24/7, including weekends and holidays with little to no wait times.

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