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Spring Survey 2012 Results

Part I - Health Insurance Fraud: A focus on Consumer Rights

PROGRAM DETAILS:

If you’ve had a health condition that your insurance won’t cover, you know how difficult it can be to navigate the healthcare industry. Two consumer advocates join this program to help us understand where to get help for claims, as well as how to identify fraudulent insurance companies. Sean Dilweg is the Insurance Commissioner in Wisconsin and one of the leaders of the National Association of State Insurance Commissioners. Lin Osborne is President and Founder of Health Plan Navigator, an organization that helps people who are having trouble with their healthcare plans or medical bills. Also joining the program is Joseph Foti, an attorney whose wife was forced into rehab before having surgery because the insurance company pressured the doctor to wait.

Mr. Dilweg answers the question, how can people really be confident that they have the coverage for that event that may happen? He suggests when to contact your state’s Insurance Commissioner and gives the uplifting statistic that at least half the complaints that come through their door in Wisconsin fall back in favor of the consumer. Mr. Dilweg also talks about how to identify fraudulent insurance companies, stressing the importance of sticking to licensed providers and licensed insurers and what tools are available to research insurance companies.

Mr. Foti’s wife Tameka was hospitalized and underwent surgery for septic shock. Tameka nearly died from infections that developed while undergoing rehab at under-equipped facilities that insurance would cover while she waited to have a second needed surgery. She’s very sick, and had doctors kept her in the hospital where she was getting quality care this wouldn’t have happened.

Lin gives advice on how we as nonmedical people can make judgments about what’s quality care, and what avenues are available to remedy insurance disputes. Lin and Dr. Dilweg talk about what forms you should be weary of signing when admitted to the hospital, the advantages of online insurance companies, and they explain the new, very complicated, Medicare Advantage plans.

Whether it’s fraudulent health insurance or it’s just complicated health insurance, the question is, can you rely on your insurance when someone in your family is sick? Listen to the webcast for a discussion on how to be a smart healthcare consumer.

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EXPERTS & GUESTS:
Lin Osborne,
President and Founder of Health Plan Navigator
Lin Osborn, President and founder of Health Plan Navigator, turned an avocation into a successful patient advocacy group in 1998. That was the year Choices in Healthcare was founded in order to assist people who were having trouble with their managed care plans. In the fall of 2001, having outgrown the original Choices form, Ms. Osborn founded Health Plan Navigator.... more >

Sean Dilweg,
Commissioner of Insurance
Mr. Dilweg serves as Commissioner of Insurance in Wisconsin. Prior to this appointment he served as the Executive Assistant to the Secretary of the Wisconsin Department of Administration (DOA) from 2003 to 2006. In addition to managing key agency activities, including external communications, tribal negotiations and state finances, he advised the Secretary of the Department of Administration and Governor Jim... more >

Joseph Foti,
Husband of suffering patient
Mr. Foti is a labor relations attorney for a large medical center in Brooklyn, New York. He was always secure in knowing his family had excellent coverage if anyone ever became ill. Never in a million years would he have imagined that he would be asking for additional money to cover medical expenses for his family, but he would later... more >

TRANSCRIPT:

  1. Introduction LISTEN
  2. Consumer Support LISTEN
  3. Medicare Advantage Plans LISTEN
  4. Joseph’s Story LISTEN
  5. Become an Aggressive Healthcare Consumer LISTEN
  6. Resources and Advice for Consumers LISTEN

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