Meet Your New Favorite Superhero, the Insurance Counselor
This week, DaVita is celebrating its Insurance Counselors and Insurance Specialists across the Village. These teammates play an important role in educating patients about insurance options. In celebration of this week, Sue Carr, an insurance counselor in Nevada, shares what she does for the Village, and describes how she both educates her patients and advocates for them when issues arise.
I call myself the insurance lady at my centers. I came to DaVita four years ago after a career as a welfare worker in Minnesota and an eligibility specialist at University Medical Center in Las Vegas. Today, I am an insurance counselor (IC) with the Insurance Management Team (IMT), supporting seven centers in the Las Vegas area. My two most important jobs are to educate patients on their insurance options, and advocate for patients when issues arise with employers or insurance providers.
I am on the road frequently and plan out my days based on my patients’ treatment days. As an IC, I get to know my patients and their insurance coverage. Health care insurance, especially for dialysis patients, can be extremely complicated, so I provide education to help them understand their insurance benefits and the out of pocket expenses they might expect. I also help answer their insurance questions, and tell them that when I’m not at the center in person, I’m only a phone call away.
One year, during open enrollment (the busiest time of year for an IC), we received news that one of our insurance contracts was up for renewal and was under negotiation. When this happens, it can become a major issue for patients, especially if the contract terminated. My IMT teammates, along with our amazing field partners, help support patients during these situations by quickly jumping into advocacy mode. We identify the affected patients, explain the situation, and educate them on the Continuity of Care laws could protect them. Many patients will also advocate for themselves, writing letters to the local government officials asking for support in reaching an agreement.
Our patients can become overwhelmed and scared in these situations. I work very closely with our social worker Meghan Hoefs and together we spend a lot of time with our patients to make sure they know we are doing our best to support them and to make sure they understand any changes to their insurance.
Some worry they might have to change to a different dialysis center or doctor, or even cancel their insurance to stay with DaVita. It is my job as an insurance counselor to provide fact-based and objective education on all available insurance plans and other in-network dialysis providers, and explain how each change may affect their access to care and potential out-of-pocket costs.
My job is to advocate for and educate patients, even if their insurance changes and DaVita is no longer in-network. I remind patients who transfer to another dialysis provider, due to insurance changes that it could change back again next year, and DaVita might be back in-network again.
I love working with dialysis patients, including advocating for them whenever the situation calls for it. Because in the end, we are all here because of our patients!