Under The Coverage

Nova Healthcare Administrators
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Under The Coverage

We talk to people who work behind the scenes but are also consumers of healthcare. We ask them what they know now that they wish every healthcare consumer knew. Find us on Twitter @UndrTheCoverage or send us a question to podcast@novahealthcare.com

  1. The Price of Panic: What you need to know about ER Expenses

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    The Price of Panic: What you need to know about ER Expenses

    🚑 Ever wondered why a quick trip to the ER or a ride in an ambulance can lead to a shocking bill in your mailbox? In this episode, we break down everything you need to know about emergency services and the costs that come with them. From understanding when to dial 911, to the hidden fees that could catch you off guard, we’ve got you covered. We’ll also dive into the No Surprises Act—what it protects you from, and where it falls short—especially when it comes to those pricey ambulance rides. Whether you're trying to avoid financial surprises in an emergency or just want to be better prepared, this episode is a must-listen. Tune in and take control of your health care costs before the unexpected happens! 🔑 Episode Highlights: - When to Use Emergency Services: Clear guidance on when to head to the ER vs. seeking care elsewhere. - Breaking Down Costs: A look at the fees you can incur - The No Surprises Act: What it covers, what it doesn’t, and how it impacts your emergency bills. - Avoiding Financial Shocks: Tips on how to protect yourself from unexpected charges in an emergency. - Advocating for Yourself: Practical advice on negotiating bills and ensuring you’re only paying for what you need. - Join us for a crash course in understanding emergency care costs—before you're faced with the bill! 🚑💡 Subscribe now and never miss an episode of health benefits know-how!

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  2. The Power of a Caring Nurse in Your Corner

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    The Power of a Caring Nurse in Your Corner

    🩺Ever been faced with a scary, serious health situation and felt overwhelmed and unsure of where to turn for help? In this moving episode, we hear from Allison, a former patient whose life was profoundly impacted by the care and support provided by one of Nova's case management nurses. Allison recounts her journey, starting from the surprise of learning she was pregnant with twins to navigating a complicated pregnancy, serious health condition of one of her babies, and insurance challenges while out of state for specialized care. 🚼 🔑Episode highlights include: - The role of nurses in health insurance - How to stay organized and proactive to help better manage care - The importance of mental health and well-being when dealing with serious health diagnoses Allison shares her deep gratitude for the support she received, including nominating her case manager for a regional excellence award, which she won. The episode beautifully highlights how a compassionate case manager can make all the difference during medical crises. Tune in to hear about how the unique benefits of having knowledgeable nurses from the insurance side involved in the process, and how their understanding of both medical and insurance landscapes can play an instrumental role in guiding you through your most stressful health situations. 🎧

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  3. Preventive Services 101

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    Preventive Services 101

    🩺 Ready to take control of your health? Join Jolene and Sara for a quick, fun, acronym-filled dive into the world of preventive services, zero dollar copays and the ACIF and USPSTF! In this short episode, you'll learn why preventive care is essential and how the Affordable Care Act (ACA) guides your zero copay benefits. We'll cover: - Who is the USPSTF and the ACIP? - What’s considered preventive - Key screenings, counseling, vaccines and medications you should know about. - How the Affordable Care Act (ACA) helps cover these preventive services. Tune in to get the scoop on keeping healthy, making informed choices, and ensuring you’re getting the preventive services you need—all with a smile and a bit of fun! Don’t miss out—hit play now and start your journey to better health! 🎧✨ Links to learn more: Looking for quick access to the USPSTF A&B Recommendations? https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations Find ACIP recommendations and guidelines for vaccines https://www.cdc.gov/vaccines/?CDC_AAref_Val=https://www.cdc.gov/vaccines/hcp/acip-recs/index.html#print Understanding the ACIP & How Vaccine Recommendations are Made in the US https://www.youtube.com/watch?v=WWf4xVw1-PE

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  4. Breaking Down Insurance Premiums for Medical Benefits

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    Breaking Down Insurance Premiums for Medical Benefits

    💸 Ever wonder why your medical benefits cost an arm and a leg? Join Jolene and Sara in this short and lively episode as they dive into the reasons behind the high price tags on insurance premiums in the United States. This episode unpacks: • The average annual cost of coverage in the United States. • The pros and cons of cutting-edge treatments and pricey new drugs. • The role of chronic diseases and an aging population in driving up costs. Get ready for a quick, engaging, and informative discussion that makes sense of the dollars and cents behind your medical benefits. Hit play to become a smarter healthcare consumer! Subscribe now and never miss an episode of healthcare know-how! 🎧💡

    ١١ من الدقائق
  5. Unpacking the Term Medically Necessary

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    Unpacking the Term Medically Necessary

    Have you ever had a service reviewed or denied by your insurance with the explanation that it wasn’t “medically necessary”? Join us as our medical management team helps us understand what medical necessity really means. We’ll explore: • When something is reviewed for medical necessity • Real-life examples • Appeals process • Practical advice for navigating this complex part of health insurance. Tune in and empower yourself with the knowledge to navigate medical necessity determinations with confidence. 🎧💡

    ١٩ من الدقائق
  6. Post-Hospital Care: Staying Healthy & Staying Home

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    Post-Hospital Care: Staying Healthy & Staying Home

    🏥 Whether it’s you or a loved one in the hospital you know that going home is a great relief, but it can also be worrisome. It can be a challenge to absorb and remember all the notes you get before discharge. You can call the doctor’s office, but you might also get a phone call from a nurse at your insurance company. Have you ever wondered why they’re calling? Jolene and Sara are here to uncover the secrets with two industry experts! In this engaging and informative episode, we dive into the world of inpatient hospitalization and the critical role nurses play in keeping patients from bouncing back into the hospital. Join us for a lively conversation where Jolene and Sara talk to the experts to discuss: • Common challenges faced during the transition from hospital to home. • Why that post-discharge call from a nurse is a game-changer. • How nurses can help prevent costly readmissions. Get ready for a fun, quick, and eye-opening discussion that highlights the power of post-hospital care and how a simple phone call can make all the difference. Hit play and discover how to make the most of your recovery journey! Subscribe now and never miss out on these essential healthcare insights! 🎧💡

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  7. Medical Gear Decoded: DME, Prosthetics, and Appliances Explained!

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    Medical Gear Decoded: DME, Prosthetics, and Appliances Explained!

    🏥 Ever wonder what exactly counts as Durable Medical Equipment (DME), a prosthetic, or an appliance? Join Jolene and Sara in this quick and lively episode as they team up with registered nurses Lorene and Stefanie to demystify these categories of medical devices. Our expert panel will break down the key differences, helping you understand what your plan covers and how to navigate your healthcare options like a pro. 🔑 Episode Highlights: • DME: Durable, reusable medical equipment for home use. • Prosthetics: Custom-made devices to replace missing body parts. • Appliances: Supportive devices that improve body function or stability. Get the lowdown on what makes each category unique and how to ensure you're covered. From wheelchairs to hearing aids, we’ve got the info you need to make informed decisions about your health care. Tune in for a quick, fun, and informative session that turns complex medical jargon into clear, actionable insights. Hit play and become the master of your medical benefits today! 🎧💡 Subscribe now and never miss an episode of healthcare know-how!

    ١٥ من الدقائق
  8. Unlock Your Insurance Superpowers: Navigating Out-of-Network Benefits!

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    Unlock Your Insurance Superpowers: Navigating Out-of-Network Benefits!

    Ever felt like navigating your health insurance is like solving a riddle wrapped in a mystery? Fear not, dear listener! In this action-packed 10-minute episode, we're here to demystify the world of out-of-network benefits. Join us as we unveil the secrets to discovering if you have out-of-network benefits and how to use them like a pro. Whether you’re planning a trip, switching doctors, or just want to be prepared for the unexpected, we’ve got you covered. Get ready to become the superhero of your own healthcare journey. Tune in for a quick, informative, and downright fun dive into the ins and outs of your insurance network. By the end of this episode, you'll have the tools to confidently navigate your benefits and make the most of your healthcare plan. 🌟 **Highlights:** - What are out-of-network benefits and why should you care? - Step-by-step guide to finding out if you have these benefits. - Tips and tricks for using your network when you go out-of-network. - Real-life scenarios and expert advice to make you an insurance savvy superstar. Don't miss out—hit play and empower yourself with knowledge that could save you time, money, and stress. Because understanding your health insurance shouldn’t be a headache, it should be your superpower! 💪✨ Subscribe now and stay tuned for more quick and easy tips to master your health and wellness!

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We talk to people who work behind the scenes but are also consumers of healthcare. We ask them what they know now that they wish every healthcare consumer knew. Find us on Twitter @UndrTheCoverage or send us a question to podcast@novahealthcare.com

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