186. Stop Overpaying for Your Health Insurance: EOBs, Tiers & Avoiding Bad Bills

Ever felt like your insurance company is gaslighting you? Dr. Altamash Raja shares a real story that turned a routine billing error into a masterclass on how to actually navigate health insurance. From copays and deductibles to hidden tiers and the fine print that drains your wallet - this Progress Note breaks it all down.

Join hosts Dr. Darsh Shah and Dr. Altamash Raja as they cut through the noise, explain the system in plain English, and arm you with the knowledge to advocate for yourself next time your claim gets “lost”.

TIMESTAMPS
00:36 Insurance Negotiations Frustrations
06:33 Understanding Health Insurance Terms
17:26 Navigating Insurance Plans and Benefits
23:56 Navigating Insurance Verification
25:52 The Business Side of Healthcare
26:37 Challenges in Inpatient Rehab
28:41 Understanding Healthcare Metrics
31:59 Emergency Visits and Insurance
34:10 Planning for Medical Emergencies
37:14 Insurance Tiers Explained
40:01 Practical Tips for Managing Insurance
46:20 Final Thoughts and Recap
48:10 Outro and Disclaimer

SOURCES

[00:06:00] — Premiums, Deductibles, Coinsurance & Copays Explained – Aetna

[00:17:00] — HMO vs. PPO: Which Is Right for You? – Humana

[00:34:00] — What Is a “Surprise Medical Bill” and What Should I Know About the No Surprises Act? – Consumer Financial Protection Bureau

[00:34:00] — No Surprises Act: Balance Billing Rules for Emergency and Air Ambulance Services – Centers for Medicare & Medicaid Services

[00:40:00] — Navigating the Insurance Appeals Process –Patient Advocate Foundation