Blog/News

Out-of-Network Ancillary Surgical Charges

When we are about to have surgery at a hospital or outpatient surgical center, we usually check for network status of the facility and surgeon, to be sure we are getting the best benefit for that service.  As we know, staying within the network of our plan will result in lower cost sharing for us. … Continued

Tips From Paula: Setting Up An Online Account

One of the easiest and most efficient ways of tracking your insurance claims and other activity is by setting up an online account. Most, if not all, insurance carriers, now have an online portal available.  This gives members the ability to perform many simple tasks, such as viewing and tracking claims, downloading  forms, looking up … Continued

Tips from Paula: Understanding Balance Billing

As Employee Advocate here at Acadia Benefits, I spend a good deal of time helping our customers understand their bills from providers.  It is often confusing and hard to understand these statements.  The first thing we look for on a bill is some sort of reference to a payment or reduction from the insurance company.  … Continued

Tips From Paula: Coordination of Benefits Letter

Occasionally,  two insurance plans work together to pay claims for the same person. That process is called coordination of benefits. Insurance companies coordinate benefits to avoid duplicate payments by making sure the two plans don’t pay more than the total amount of the claim. They may also need to establish which plan is primary and which … Continued

Tips From Paula: Obtaining Medical Records for Disability Claims

I have been very busy this summer working on our customers’ disability claims! One recurring issue I have come across is obtaining medical records for the insurance companies’ review. Most large medical practices now “outsource” their medical records distribution to a third party.  These third parties usually want payment for their time and resources.  The … Continued

Tips from Paula: Understanding your lab work benefits

As the Employee Advocate here at Acadia Benefits, I get several calls each month from our customers who are unsure of how a claim for “routine lab work” was processed.  Because their doctor ordered this lab work as part of their routine physical, many people assume the lab work will be covered in full, similar … Continued

June 1st Breakfast Seminar

We hope you can join us for a breakfast seminar:   Healthcare Cost Reduction Initiatives and ERISA Compliance Considerations: Tips for 2017 Open Enrollment   Thursday, June 1st 7:30 – 9:30AM   Pierce Atwood, LLP 254 Commercial Street Portland, ME 04101   DESCRIPTION With the move away from fee for service to value based reimbursement … Continued

The Importance of Timely Filing For Claims Paid in Error

As we head into a new benefit year for many of our customers, it may be a good time to remind people about the importance of using the correct ID card during the transition time. There are occasions where the new ID card may not have been received by a member. In addition, their “old” … Continued

Tips from Paula: Establishing A Relationship With Your PCP

During our open enrollment presentations, and here on our blog, we often remind our customers of the importance of wellness exams with their Primary Care Physicians (PCPs).  The benefits of these wellness exams are not just health-related.  We are finding more and more that it is extremely important for patients to establish a relationship with their … Continued

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