VSON can help patients take a proactive approach to finding insurance options for treatment

Bright Health’s recent departure from the Summit County health insurance market has created another gap in services for both patients and insurance groups.

But with some of the best orthopedic surgeons in the world based at Vail-Summit Orthopedics and Neurosurgery facilities in Frisco, Colorado and operating out of Dillion Surgery Center, it certainly makes sense that local patients could access these services and not have to travel to metro Denver or beyond. for other alternatives. And with enrollment now open in the state, patients looking to retain or guarantee access next year are encouraged to do plenty of research to find a plan that will keep them in the VSON care community.

Carrie Thomason, VSON’s chief financial officer, says she’s been working hard to try to provide options and education for patients who want local access to surgery, sports medicine, and more. But Thomason says patients need to take a similarly proactive approach in ensuring their current coverage, rather than facing any unexpected billing issues in the future.

“Our goal as an osteopathic practice is to provide care to the community, and we do what we can to help patients
Understand the local insurance market and get the best possible coverage.” – Amanda Lehrer

“Unfortunately, there aren’t a lot of local options, as only three insurers offer patients in-network coverage for our services in the individual market — plans from Rocky Mountain Health, part of United Healthcare System, as well as plans from Anthem Blue Crossing Blue Shield and Cigna, Thomason says. “Bright Health pulled out so quickly that many patients were left scrambling.”

The big problem for patients, Thomason says, are those people who split time between Denver and Summit County and believe — or hope — that front-range insurance coverage will automatically apply for VSON visits.

“Everything is very different, depending on where you live and on the basis of primary residence,” she says. “If you live in Denver, that plan may not be accepted here in Summit County. We’ve run into this a lot, especially with Anthem’s CU health plan or even Kaiser Permanente, if people have coverage without extended nets.”

Thomason encourages patients to do their research—as frustrating as it can be to try to contact health care insurers or search Web sites—to make sure their narrow network will cover VSON’s services.

“As you plan your insurance options, you need to focus on what you think your use might actually be and how much you expect to spend, and figure out the best plan for the care you plan to use,” says Thomason. “This is especially important if you have adult children who fall out of your insurance coverage as they approach the age of 26.”

VSON helps patients get access
The easiest possible access to the local
Orthopedic services.

Amanda Leyrer, MS, ATC, OTC, SA, director of clinical operations for VSON, says VSON does everything it can to make sure local patients have the easiest possible access to local orthopedic services.

“Our goal as a practicing osteopath is to provide care to the community, and we do what we can to help patients understand the local insurance market and get the best coverage possible,” she says.

Leyrer agrees that patients remain in a difficult situation because many of these insurance decisions are ultimately left up to them, with relatively few guidelines available.

“It’s especially difficult when insurance companies aren’t transparent to patients. A lot of it comes down to knowing what questions to ask and always doing your own due diligence,” she says. “It’s important for people to have coverage that allows for acute care, especially with an active population we’ve got. Take the time to understand your benefits.

Leyrer suggests that potential patients with employer-sponsored insurance pay close attention and have these questions ready for HR staff during open enrollment season, when a candid conversation with a knowledgeable advocate can help secure the right coverage — or avoid unexpected billing. On the road .

“There are so many different forms of insurance out there, and they’re all trying to get you a piece of the business, so you really need to know what you’re signing up for before making that option,” Leyrer adds.

Some patients can also take advantage of the discount offered by paying cash for services, Lerer says, but this also requires some foresight and may only be appropriate for certain situations.

“We offer self-pay cash discounts on a case-by-case basis, and there are benefits to that, but it depends on the procedure. It’s definitely another way to provide some relief.”

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