I know everyone loves to throw darts at insurance companies. I am not going to defend them. They have worked hard to get most of their reputation. Remember though that the people working for the insurance companies are just like you and me.
1) Talk to your insurance company! Contact your insurance company and get a caseworker. That way you are can talk to ONE person and work your way through the various ups and downs of medical needs and bills. Your caseworker should be able to pre-approve needed visits, equipment, out of network issues, etc.
2) READ your insurance policy! Call the insurance company if there is a gray area. You want to be sure you know exactly what is in-network, out-of-network, covered under therapy, durable medical goods, what do they consider clincal trials. Make a list of exactly what affects your medical condition and look for those parts of the policy.
3)Do not try to blindside your insurance! I have had friends go to a hospital they knew was outside their insurance but they hoped was better for their child. They thought that once they were there they could talk the insurance into covering them in the hospital. WRONG. That just means you have to pay more money.
4) Know about and use the appeals process! I live hours from a large city and many of my old insurance's in-network mobility providers. I found out that I could appeal their out of network status of a local mobility provider based on distance and my inablity to get to the large city. I was also able to use an appeal to get in-home therapy because of my condition. I had to provide doctor letters.
5) Understand that your hospital and your insurance company have a deal. Your insurance company should send you a letter that says, "You owe General Hospital $341.00" If the hospital bills you for more then that you need to make some calls and find out why.
6)Look over all insurance claims, and bills! We have found thousands of dollars of billing errors over the years. Simple things like billing the wrong insurance company, the wrong child's name, or social security numbers that are wrong.
7)Never accept that a mistake on the insurance company or hospital's side means you have to pay. I was told that I had to pay for the entire amount of one of my child's births because our old insurance company falsely okayed coverage, then denied 2 years later. The hospital then turned to us for pay despite the fact that at the time of the birth we provided the right insurance company. We had to press the issue but they finally billed the correct insurance and all was taken care of. During this all we were told that despite their mistake because of the length of time involved we HAD to pay.
While I am not a huge insurance fan I would MUCH rather have the insurance of my choice then none at all. I highly recommend using a large dose of politeness and honey when talking to your insurance representatives or caseworker. They have information you need and could make your life better.
When you are looking at your medical bills and trying to pare down the expenses. Start with your insurance!