Why is it so complicated?
Physicians and other providers give instructions on what patients need to do next, but there are too many options for medications, imaging labs, and specialists, few of which may be locally accessible and covered by the patient's insurance. In order to ensure that patients follow through with doctors’ care plans, patients need tools to support them through the many decisions they need to make. Patients need help identifying the services that are local, accessible, and covered by their insurance.
When a provider prescribes medication, patients often don’t know if the prescription will be covered by their insurance, or where to go to get it filled. Patients need to decide what pharmacy to go to, and then determine if they should ask for a generic, or identify a specific brand that is covered by their insurance.
When a provider tells a patient they need to get an MRI, CT, ultrasound, etc. they often don’t know where to go for such services, or if the test will be covered by their insurance. Patients need to find a relevant imaging center, that is locally accessible and covered by their insurance.
Referrals to Specialists
When a provider tells a patient to see a specific type of specialist it is often hard to narrow down the options, and find someone local, who is also in network. Patients need to find a relevant specialist that is locally accessible and in-network.
Patients need assistance in navigating insurance plan coverage, understanding costs of comparable medications, deciding where to go for tests, and determining which specialist to see next.