Premium, Deductible, Copay, Coinsurance, Covered Services, Provider Network…

Here’s a little quiz. Can you define the terms above?

Great. Now, what if you asked your employees to do the same? In a survey conducted at the end of last year, only 49% of insured Americans were confident that they understood the nine most basic health insurance terms. What can be said when fewer than half of us understand how our insurance works? When there are such fundamental gaps in patient knowledge, it becomes difficult to get them to use their insurance for treatment, and then for lack of care, it’s hard to make them healthy.

We know that this basic misunderstanding is a significant burden on HR teams, who most employees will defer to for answers, or worse yet, they might not defer to anyone. It’s also a huge hassle for employees themselves, who are often misusing or not getting the most of their plans.

In the last month at Sherpaa, 39% of our client interactions were insurance-related. Sometimes, we answered questions as simple as “What’s my copay on my birth control?” and “How many times can I see a physical therapist under my insurance plan?” Just a small investigation on our part prevents the first client from overpaying and the second from exhausting their coverage.

We did more elaborate work, too. When one of our clients turned 26 and had to leave his parents’ insurance plan, he was at a loss for finding the best option. It’s important to us that all of our clients fully understand what they’re signing up for, and more important that they sign up for a plan that’s valuable to them. So we put together a plan and benefits comparison for his unique needs. When he’d chosen his plan, we walked him through his forms, and helped him enroll.

In one case, a client of ours needed the HPV vaccine and found it almost impossible to get prior authorization because he was male. Our different departments put their heads together and figured out a way to coordinate care between his pharmacy, doctor’s office, and insurance carrier. Because we were able to engage both the healthcare industry and the insurance industry at once, our client received prior authorization, saving him quite a bit of his salary (the vaccine, minus the cost of the doctor who administers it, can be upwards of $500!)

What all these cases have in common are the potential for the client to spend much more than necessary, or to spend hours sleuthing only to end up with a feeble answer. We at Sherpaa know there’s a smarter way. Sherpaa’s Insurance Guides have dealt solely with these sorts of problems for years, so they’re able to answer these questions and resolve billing problems much quicker than an HR team with other duties to fulfill. Our Guides also work closely with doctors to ensure everything is not only cost effective and without hassle, but quality, necessary care.

So if you did poorly on our quiz, don’t fret. When your business, HR department, or employees need help navigating health insurance and the healthcare it covers, you can always ask Sherpaa for help.

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