Ambulatory care, which encompasses a wide array of healthcare services provided outside of a hospital setting, requires careful consideration of insurance policies tailored to its unique demands. In this introductory blog post, we'll delve into some essential questions to ask when evaluating ambulatory care insurance coverage.
1. What types of procedures and services are covered under the policy?
Ambulatory care encompasses a wide range of healthcare services. Make sure the policy covers the specific types of procedures and services you provide.
2. How are different ambulatory settings covered?
Ambulatory care can be provided in various settings like outpatient clinics, hospital outpatient departments, ambulatory surgical centers, and even home health services. It's crucial to understand how the insurance policy covers these various settings.
3. What is the coverage limit per claim, and what is the aggregate limit?
The coverage limit is the maximum amount the insurance company will pay for a claim. Aggregate limit is the total amount the insurance company will pay out for the policy term. These limits should be sufficient to protect your assets in the event of a lawsuit.
4. Does the policy cover telemedicine services?
As telemedicine becomes more widespread, especially in an ambulatory setting, it's important to know whether your policy covers these services.
5. What kind of assistance does the insurance company provide in the event of a lawsuit?
In addition to financial coverage, many insurance companies offer legal support in the event of a lawsuit.
6. Does the policy cover services provided by all staff at the facility?
In ambulatory settings, a range of healthcare professionals may provide care, including physicians, nurse practitioners, physician assistants, and registered nurses. Make sure the policy covers all individuals providing care.
7. Are there any exclusions or limitations in the policy?
Make sure you understand any limitations or exclusions in the policy, such as certain procedures not being covered, or certain situations (e.g., intentional misconduct) not being covered.
8. What is the policy on prior acts or "tail" coverage?
If you switch insurers or retire, you may need coverage for claims made after the policy period but which arise from care provided during the policy period. Some policies include this, or it can be purchased separately.
9. Does the malpractice insurance policy offer consent or agreement to settle?
This provision would allow you to approve or deny any settlement agreement in your case. Without this, the insurance company may settle a claim without your consent.
10. What is the cost of the premium, and what factors may cause the premium to increase?
Understand how much you will be paying for the coverage and what factors (e.g., claims history, risk factors associated with the types of care provided) may influence this cost.
Again, since the conditions and coverage can vary significantly between different insurance providers, it is advisable to consult directly with potential insurers to get the most accurate and comprehensive answers.
Contact SelectFirst Insurance today for help with your Medmal insurance. Call (888) 966-3881or Email us at info@selectfirstinsurance.com.
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